Passive voice in OET letters: when to use 'was admitted' and 'has been commenced'
Use the passive voice in an OET Nursing letter when the action matters more than who did it, such as 'She was admitted on 4 March' or 'His dressing has been changed daily'. Use the active voice when the person acting matters or when you make a request ('I would be grateful if you could...'). Most good letters mix both, and the passive must be formed correctly: a form of 'be' plus the past participle.
Why the passive matters in nursing letters
Clinical letters describe a lot of things that were done to the patient: admitted, assessed, prescribed, transferred, discharged. In most of these, who did it is either obvious (the ward team) or unimportant to the reader. The passive voice lets you keep the patient or the treatment at the front of the sentence, which keeps the letter focused.
- Active: "The emergency team admitted Mr Silva on 4 March."
- Passive: "Mr Silva was admitted on 4 March."
The passive version is shorter and puts the patient first. That supports Conciseness & Clarity as well as a professional tone (Genre & Style).
How to form it
The passive is always a form of be + past participle. The tense is carried by be.
| Tense | Form | Example |
|---|---|---|
| Past simple | was / were + participle | "She was admitted on 4 March." |
| Present perfect | has / have been + participle | "His dose has been increased to 40 mg." |
| Present simple | is / are + participle | "Her dressing is changed every second day." |
| Present continuous | is / are being + participle | "He is being monitored for signs of infection." |
| Past perfect | had been + participle | "She had been prescribed warfarin before admission." |
| Future / request | will be / should be + participle | "His sutures should be removed on 20 March." |
| Modal | can / must be + participle | "The catheter can be removed once he is mobile." |
Common irregular participles in letters: given, taken, seen, written, shown, undertaken, withheld.
When to use it, and when not to
| Use the passive | Use the active |
|---|---|
| Admission, transfer, discharge: "was admitted", "is being discharged" | What the patient does: "She walks with a frame." "He reports less pain." |
| Treatment given: "was prescribed", "was given", "has been commenced" | Your purpose: "I am writing to refer..." |
| Investigations: "An X-ray was taken", "Bloods were collected" | Requests: "I would be grateful if you could review..." |
| Instructions about care: "Her wound should be reviewed weekly." | When the person acting matters: "Her daughter will collect her." |
| When the doer is unknown: "He was found on the floor." | When the passive would hide responsibility the reader needs |
A good rule: events and treatments → often passive; the patient's abilities, your purpose and your requests → active. For more on requests, see closing paragraph examples.
Common errors
| Error | Wrong | Right |
|---|---|---|
| Missing be | "He admitted on Monday." | "He was admitted on Monday." |
| Missing participle ending | "The wound was dress daily." | "The wound was dressed daily." |
| Wrong participle | "She was gave morphine." | "She was given morphine." |
| Wrong tense of be | "His dose has increased to 40 mg." (meaning someone increased it) | "His dose has been increased to 40 mg." |
| Active with the wrong subject | "The patient discharged home." | "The patient was discharged home." |
| Passive with happen verbs | "The fall was occurred at night." | "The fall occurred at night." |
The last row matters: verbs such as occur, happen, arrive, deteriorate and improve have no object, so they cannot be passive. "Her condition was deteriorated" is wrong; write "Her condition deteriorated."
Note the difference in the fourth row. "His dose has increased" (active) suggests it changed by itself; "His dose has been increased" (passive) says a clinician changed it. In medication sentences, the passive is usually what you mean. See medications in OET letters.
Do not overdo it
A paragraph made only of passives becomes hard to read:
~~She was admitted on 4 March. An X-ray was taken. A fracture was diagnosed. Surgery was performed. Physiotherapy was commenced. Mobility was improved.~~
Better:
She was admitted on 4 March with a fractured left hip, which was repaired surgically the next day. Since starting physiotherapy, she has been walking short distances with a frame.
The second version combines events, uses linking words (see linking words and cohesion) and switches to the active when describing what the patient does.
Worked example (invented case)
Notes (invented): Mr Tomas Silva, 67. Adm 4/3 SOB, fever. CXR: R lower lobe pneumonia. IV abx 4/3–7/3, changed to oral 8/3. O2 weaned 7/3. Mobilising independently. D/C 10/3. Complete oral abx 14/3. Repeat CXR 6/52.
Paragraph:
Mr Silva was admitted on 4 March with shortness of breath and fever, and a chest X-ray confirmed right lower lobe pneumonia. He was treated with intravenous antibiotics, which were changed to oral antibiotics on 8 March, and his oxygen was weaned the day before. He is now mobilising independently and is being discharged home today. He should complete his oral antibiotics on 14 March, and a repeat chest X-ray is recommended in six weeks.
Count the voices: passives for treatment and plans ("was admitted", "were changed", "is being discharged", "is recommended"); active for the patient's own progress ("He is now mobilising"). That balance reads naturally to a clinical reader.
Practise
Rewrite three sentences from your last practice letter, once in the active and once in the passive, and decide which reads more clearly. Then try a full case in timed practice or check a letter you have already written; medEmu marks grammar problems such as a missing be on your own sentence, with the correction and the reason. For the wider grammar picture, see the Language criterion guide.
Sources
This guide is medEmu's writing advice, not official OET guidance; the example is invented. The network used for this run could not reach oet.com, so no OET test facts are stated beyond the criterion names. For OET's official Writing information and assessment criteria, see oet.com.