Relative clauses in OET letters: using who, which, whose and where to combine case notes
Relative clauses (with who, which, whose, where or that) let you join two case-note facts into one clear sentence, for example 'Mrs Tan, who lives alone, was discharged today.' In an OET Nursing letter, use them to add relevant detail to a person or thing without starting a new sentence, use commas around extra information, and avoid stacking several clauses in one long sentence.
Why relative clauses help in OET letters
Case notes are lists of short facts. If you turn each fact into its own sentence, the letter becomes choppy: "Mrs Tan is 79. She lives alone. She was admitted on 2 May. She had a fall." If you join everything with "and", it becomes a run-on sentence.
A relative clause is a middle way. It attaches one fact to a noun inside another sentence:
Mrs Tan, who lives alone, was admitted on 2 May after a fall.
Accurate, varied sentence structure is part of the Language criterion, and well-combined sentences support Conciseness and Clarity. For turning notes into sentences in general, see case notes to full sentences.
The relative words you need
| Word | Refers to | Example (invented) |
|---|---|---|
| who | people | "Her son, who visits daily, will help with her medicines." |
| which | things, or a whole idea | "The wound, which was dressed today, is healing well." |
| whose | possession (people or things) | "Mr Ali, whose wife has dementia, is her main carer." |
| where | places | "She will return to the care home where she has lived since 2022." |
| when | times | "She was reviewed on Monday, when her drain was removed." |
| that | people or things, identifying clauses only | "The tablets that were stopped are listed below." |
Extra information vs identifying information
This is the distinction most candidates find difficult, and it controls the commas.
| Type | Commas? | Use it when | Example |
|---|---|---|---|
| Non-identifying (extra information) | Yes, before and after | You already know who or what it is; the clause just adds a fact | "Mr Costa, who is 81, lives with his daughter." |
| Identifying (defining) | No | The clause tells the reader which one | "The patient who was admitted yesterday has been discharged." / "The cream that she uses twice daily has run out." |
Patients are usually named, so clauses about a named patient are almost always non-identifying and need commas:
- Wrong: "Mrs Chen who has type 2 diabetes was admitted..."
- Right: "Mrs Chen, who has type 2 diabetes, was admitted..."
Worked example: from notes to sentences (invented case)
Notes (invented): Mr Jonas Abara, 76. Retired teacher. Wife Grace — main carer, has arthritis. Admitted 3 Jul, cellulitis left lower leg. IV antibiotics 3 days → oral. Leg swelling reduced. District nurse to check leg 3x/week. Lives in 1st-floor flat, lift available.
Choppy version:
Mr Abara is 76 years old. He was admitted on 3 July. He had cellulitis of his left lower leg. He was treated with intravenous antibiotics. This was for three days. He was then changed to oral antibiotics. His wife is his main carer. She has arthritis.
Overloaded version:
Mr Abara, who is 76 and who was admitted on 3 July with cellulitis of his left lower leg, which was treated with intravenous antibiotics, which were changed to oral antibiotics after three days, lives with his wife, who has arthritis and who is his main carer.
Balanced version:
Mr Abara, aged 76, was admitted on 3 July with cellulitis of his left lower leg. He was treated with intravenous antibiotics for three days and then changed to oral antibiotics, which he will continue at home. The swelling in his leg has reduced.
He lives in a first-floor flat, which has a lift, with his wife, who is his main carer. Please note that Mrs Abara has arthritis, so she may have difficulty helping him with his leg care.
The balanced version uses two relative clauses where they help and short sentences elsewhere. One clause per sentence is a good rule of thumb. ("Retired teacher" is left out because it does not affect the plan; see case notes selection.)
Reduced relative clauses
You can often shorten a relative clause by dropping "who is" or "which was":
| Full clause | Reduced |
|---|---|
| "a patient who is recovering from a stroke" | "a patient recovering from a stroke" |
| "the dressing which was applied on Monday" | "the dressing applied on Monday" |
| "her daughter, who is a nurse," | "her daughter, a nurse," |
Reduced forms are concise and natural, but check that the meaning stays clear.
Common errors and corrections
| Error | Correction | Why |
|---|---|---|
| "The patient which I referred..." | "The patient whom/who I referred..." | "Which" is for things. |
| "Her husband, that is 80, ..." | "Her husband, who is 80, ..." | No "that" after a comma. |
| "Mrs Roy who lives alone needs..." | "Mrs Roy, who lives alone, needs..." | Extra information needs commas. |
| "She has a wound which it is infected." | "She has a wound which is infected." | Do not repeat the subject with "it". |
| "Mr Lee, his wife is his carer, ..." | "Mr Lee, whose wife is his carer, ..." | Possession needs "whose". |
| "...was discharged, which she will see her GP." | "...was discharged, and she will see her GP." | "Which" must refer to something. |
| "She takes metformin, which it was started in 2020." | "She takes metformin, which was started in 2020." | Same repeated-subject error. |
All examples are invented.
Where relative clauses work well in a letter
- Opening sentence: "I am writing to refer Mrs Diaz, who was discharged today following a hip replacement."
- Linking a condition to its management: "She has heart failure, which is managed with furosemide."
- Introducing a carer or relative: "Her son, who lives nearby, will collect her prescriptions."
- Explaining a place: "She will return to Elm House, where she has lived for three years."
For opening sentences, see opening sentence examples. For connecting sentences across a paragraph, see linking words and cohesion.
Practise and check
Practise a timed letter at /writing/, or check a letter you have written to see grammar corrections with the reason for each. medEmu covers OET Writing for Nursing only; its grades are estimates, and it is not affiliated with OET.
Sources
This guide is medEmu's writing advice, not official OET guidance; all patients and details are invented for practice. 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, see oet.com.