Nursing — Discharge to the Community Nurse after Hip Surgery
A nurse discharges an 82-year-old woman to the community nurse after surgery for a fractured neck of femur. The case tests nursing hand-over: wound care, mobility, falls risk and medication need to transfer cleanly, while the surgical detail the GP already holds can be condensed.
Letter type
Discharge
Write to
Community / District Nurse
Target length
180–200 words
The case notes
Patient: Mrs Eleanor Brightwell, 82 years old
Admission: Day 8 — fell at home, fractured neck of femur; hemiarthroplasty day 1
Wound: Lateral hip wound, healing well, clips in situ — community nurse to remove on day 14
Mobility: Mobilising with a frame and once-daily physiotherapy; needs supervision on stairs
Medication: Apixaban 2.5 mg BD (until day 28 for VTE prophylaxis); paracetamol regular; senna
Medical history: Osteoporosis, hypertension, mild cognitive impairment
Nutrition / skin: Reduced appetite; Waterlow score raised — pressure-area care ongoing; intact skin currently
Social: Lives alone in a bungalow; daughter visits daily; package of care being arranged
Task: Write a discharge letter to the community nurse outlining the ongoing wound care, medication and monitoring required at home.
Writing task
Write a discharge letter to the community nurse outlining the ongoing wound care, medication and monitoring required at home.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
-
Wound status and the clip removal date (day 14)
A concrete, time-bound nursing action the recipient must perform — exactly what a hand-over letter exists to convey.
-
Apixaban with its stop date (day 28)
VTE prophylaxis with an end-point is decision-critical; the community nurse monitors and must know when it ends.
-
Mobility status, falls risk and pressure-area care
Ongoing nursing needs that shape the home visits. Skin integrity and a raised Waterlow score justify continued monitoring.
-
Lives alone with mild cognitive impairment
Directly affects medication compliance and safety at home, so it earns inclusion.
Leave out
-
Operative technique and implant details
Not needed for community nursing care; this is information for the orthopaedic record, not the district nurse.
-
The daughter's visit schedule beyond a brief mention
One line on the support network is enough; detail here is social colour that costs Conciseness & Clarity.
Criterion in focus · Genre & Style
Nursing hand-over letters are graded on whether they read as one professional briefing another — concrete tasks, dates and monitoring, not a narrative. A discharge letter that drifts into storytelling loses Genre & Style marks.
Now write the letter — and find out what is blocking your Grade B
Write a 180–200 words discharge letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.