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OET Nursing · Discharge Letter

Nursing Discharge Letter: COPD Exacerbation

A ward nurse discharges a patient after a COPD flare-up to the community nurse, with inhaler technique, home oxygen and red flags to monitor.

Task

Using the information in the case notes, write a letter to Ms Helen Ward, Community Respiratory Nurse, who will visit Mr Bell at home after discharge tomorrow.

Case notes

  • Mr Arthur Bell, 71, admitted 5 days ago with an infective exacerbation of COPD.
  • Treated with IV then oral antibiotics, oral prednisolone (reducing course, 3 days left) and nebulisers; now on inhalers only.
  • SpO2 on discharge 90–92% on room air at rest; home oxygen 2 L/min for exertion and overnight, arranged by respiratory team.
  • Inhaler technique poor on admission; re-taught, now uses a spacer correctly with prompting.
  • Lives with wife (Joan), who has mild arthritis; independent with personal care, short of breath on stairs.
  • Smoker until 10 years ago. Pulmonary rehabilitation referral sent; awaiting date.
  • Ward meals: prefers small portions; enjoys gardening; Hb normal; seen by dietitian once.

Try it yourself first: five minutes to plan, 40 minutes to write, 180–200 words in the body of the letter.

Model answer

Ms Helen Ward
Community Respiratory Nurse
Northfield Community Health Centre
6 October 2026
Re: Mr Arthur Bell, aged 71
Dear Ms Ward, I am writing to inform you about Mr Arthur Bell, who is being discharged home tomorrow following an infective exacerbation of chronic obstructive pulmonary disease (COPD). I would be grateful if you could visit him to monitor his breathing, oxygen use and inhaler technique. Mr Bell was admitted five days ago and treated with antibiotics, nebulisers and oral prednisolone. He has now completed the antibiotics and is managed on his usual inhalers, with three days of a reducing prednisolone course remaining. At discharge, his oxygen saturation is 90–92% on room air at rest. The respiratory team has arranged home oxygen at 2 L/min for exertion and overnight use. His inhaler technique was poor on admission; he has been re-taught and now uses a spacer correctly, although he still needs prompting. Mr Bell lives with his wife, who has mild arthritis. He is independent with personal care but becomes breathless on stairs. A referral to pulmonary rehabilitation has been made and he is awaiting a date. Please reinforce his inhaler technique and contact his GP if his breathlessness or sputum worsens. Should you have any questions, please do not hesitate to contact me. Yours sincerely, Charge Nurse Respiratory Ward

Body word count: 192 (target 180–200, excluding the address, date, salutation and sign-off).

Why this letter works

Purpose

The first paragraph says who the patient is, why he is going home, and exactly what the community nurse is being asked to do.

Content

Everything the visiting nurse needs is there: current medication, oxygen prescription, saturation baseline, the inhaler problem and the pending rehab referral.

Conciseness & Clarity

Meal preferences, hobbies and a normal blood result are left out; the antibiotic course is summarised in a clause.

Genre & Style

Professional nurse-to-nurse register, full sentences and no unexplained abbreviations (COPD is expanded once).

Organisation & Layout

Purpose → admission and treatment → status at discharge → social situation → specific request.

What was left out — and why

  • Routine ward details (meal preferences, hobbies) that don’t change community care.
  • Normal results (haemoglobin) that need no action.
  • The full antibiotic history — only what is still being taken matters to the reader.

Now write your own — and get it graded

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