Reported speech in OET letters: 'the patient states', 'she reports' and more
In OET Nursing letters, use reported speech to pass on what the patient or family said without quoting them word for word: 'Mr Lee reports that his pain has improved' or 'his daughter stated that he had been confused at home'. Choose a neutral reporting verb such as reports, states, says or mentions, keep the tenses consistent, and avoid direct quotation marks unless the exact words matter.
Why reported speech matters in OET letters
Case notes are full of information that came from someone's mouth: "Pt states pain 3/10", "Daughter says he wanders at night", "Pt denies chest pain", "Wife concerned re: coping". When you turn these into a letter, you need to show the reader where the information came from without copying the notes or quoting long speeches. That is reported speech.
Done well, it makes the letter accurate and professional. Done badly, it produces tense errors, awkward quotes or judgemental verbs. These affect the Language criterion and Genre and Style.
Reporting verbs that work in letters
| Verb | Use it for | Example |
|---|---|---|
| reports | symptoms or experiences | "She reports that her breathing has improved." |
| states / says | a clear statement | "He states that he lives alone." |
| mentions | a minor point | "She mentioned that she sometimes forgets her inhaler." |
| denies | absence of a symptom the patient was asked about | "He denies any chest pain." |
| is concerned / has expressed concern | worries | "His wife has expressed concern about managing at home." |
| has agreed / has declined | decisions | "She has agreed to a referral to the dietitian." |
| admits | best avoided | It can suggest guilt; use "reports" or "says" instead. |
| complains of | best avoided | Use "reports" or "has". |
"Denies" is standard clinical language, but for a non-clinical reader, "she has no chest pain" or "she says she has no chest pain" is plainer. See writing for a non-clinical reader.
Tense: when to backshift
In reported speech, a past reporting verb often moves the reported verb back one tense.
| Direct words | Present reporting | Past reporting |
|---|---|---|
| "I feel dizzy." | She reports that she feels dizzy. | She reported that she felt dizzy. |
| "I have stopped smoking." | He says he has stopped smoking. | He said he had stopped smoking. |
| "I will try the frame." | She says she will try the frame. | She said she would try the frame. |
| "I fell twice last month." | He reports that he fell twice last month. | He reported that he had fallen twice in the previous month. |
Choose one approach and stay with it within a sentence. Use present reporting for things that are still true at the time of writing. Use past reporting for something said on admission or at a past appointment. For tense choices in general, see verb tenses in OET letters.
Turning notes into reported speech
| Notes | Letter sentence |
|---|---|
| Pt states pain 2/10 at rest | "Mrs Tan reports that her pain is now mild at rest." |
| Denies SOB | "She has no shortness of breath." |
| Son says mum not eating well x 2/52 | "Her son says that she has not been eating well for two weeks." |
| Pt anxious re going home alone | "She has said that she is anxious about going home alone." |
| On adm, pt reported 3 falls in 6 months | "On admission, she reported three falls in the previous six months." |
| Pt: "I don't want to be a burden" | "She has said that she does not want to be a burden to her family." |
All details are invented. See turning case notes into full sentences for more conversions.
Worked example (invented case)
Notes (invented): Mr Tomasz Varga, 79. On admission: wife said he had been increasingly breathless for one week and sleeping in chair. Pt denies chest pain. Now: pt states breathing much better, able to walk to bathroom. Pt says he wants to keep driving. Wife worried about his memory, says he forgets tablets.
Weak version:
Mr Varga's wife said "he's been breathless for a week and sleeps in the chair". He denied chest pain. He states his breathing was much better. He complains that he wants to keep driving. His wife admits he forgets his tablets.
Problems: a long quotation, mixed tenses ("states ... was"), "complains" and "admits" sound judgemental, and "denied" is unclear for some readers.
Better version:
On admission, his wife reported that he had become increasingly breathless over the previous week and had been sleeping in a chair. He had no chest pain. He now reports that his breathing is much better and he can walk to the bathroom. He has said that he would like to continue driving. His wife is concerned about his memory and says that he often forgets his tablets.
Each sentence shows who gave the information, and the tense matches when it was said.
Practise timed letters at /writing/, or check a letter you have written to see grammar corrections with the reason for each.
Mistakes to avoid
- Mixing tenses. "She states her pain was better" should be "she states her pain is better" or "she stated her pain was better".
- Long quotations. Report the content in your own words.
- Loaded verbs. Avoid "complains", "admits" and "claims" about patients.
- Overusing "the patient". Use the patient's name or "he/she" after the first mention.
- Repeating the same verb. Vary between reports, says, states and mentions, but keep them neutral.
Related: the Language criterion, passive voice in letters and sensitive information and non-adherence wording.
Sources
This guide is medEmu's writing advice, not official OET guidance; all patients and statements 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.