Foundation · Discharge · Nursing
Wound infection after gallbladder surgery
This case practises: Leaving out what the reader doesn't need · Putting the care plan where the reader acts on it · Full sentences, not note form
Writing task
Today's date: 14 November 2026. You are the charge nurse on Ward 7 (General Surgery), Riverbend Hospital. Write a letter to Ms Grace Okafor, District Nurse, Eastfield Community Nursing Service, 40 Station Lane, Eastfield, who will visit Mrs Patel at home after her discharge today. Write in full sentences, not note form, using letter format. Aim for a body of about 180–200 words.
Case notes
In the test you get 5 minutes to read, then 40 minutes to write.
Patient details - Mrs Meera Patel, DOB 02/08/1968 (58 y.o.) - 12 Larch Close, Eastfield - Admitted 09/11/2026, Ward 7; discharge 14/11/2026 Social background - Lives with husband (works night shifts at a bakery) - Two adult sons, live in Leeds and Dubai - Enjoys gardening; sings in church choir - Non-smoker, no alcohol Medical history - K/C/O hypertension - amlodipine 5 mg OD - Hypothyroidism - levothyroxine 50 mcg OD - Appendicectomy 1990 - Allergy: penicillin (rash) Admission - 3 episodes of biliary colic in 2 months - 10/11: laparoscopic cholecystectomy, uncomplicated - 12/11: umbilical port site red, swollen, pus discharge; T 38.1 °C - Wound swab: Staphylococcus aureus (MSSA) - Started clarithromycin 500 mg BD x 7 days (penicillin allergy) - last dose 18/11 Current status - Afebrile for 24 h; redness reducing - Pain controlled - paracetamol 1 g QID PRN - Mobilising independently - Eating and drinking normally - Other 3 port sites clean and dry Discharge plan - District nurse: umbilical wound dressing every 2 days (non-adherent dressing) - Monitor for fever, spreading redness, discharge - Remove umbilical sutures 20/11 - Pt to complete antibiotic course - No heavy lifting for 4 weeks - Surgical outpatient review 08/12/2026
Write your letter
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Model answer Try writing your own letter first
Ms Grace Okafor District Nurse Eastfield Community Nursing Service 40 Station Lane Eastfield 14 November 2026 Dear Ms Okafor, Re: Mrs Meera Patel, DOB 02/08/1968 I am writing to hand over the care of Mrs Patel, a 58-year-old woman who is being discharged home today after a laparoscopic cholecystectomy and who requires wound care for an infected umbilical port site. Mrs Patel underwent an uncomplicated cholecystectomy on 10 November. Two days later, her umbilical port site became red and swollen and was discharging pus, and she developed a fever. A wound swab grew Staphylococcus aureus. As she is allergic to penicillin, she was started on clarithromycin 500 mg twice daily, and the course finishes on 18 November. She is now afebrile and the redness is settling. I would be grateful if you could dress the umbilical wound with a non-adherent dressing every two days, monitor the wound for fever, spreading redness or further discharge, and remove her sutures on 20 November. Her other port sites are healing well. Mrs Patel is mobilising independently and her pain is controlled with paracetamol as required. She has been advised to avoid heavy lifting for four weeks and will attend a surgical outpatient review on 8 December. Please do not hesitate to contact me if you require any further information. Yours sincerely, Charge Nurse Ward 7, General Surgery Riverbend Hospital
What the reader needs
- Discharged today after laparoscopic cholecystectomy (10 November)
- Umbilical port-site infection with Staphylococcus aureus
- Penicillin allergy
- Clarithromycin, course ends 18 November
- Dressing every two days with a non-adherent dressing
- Monitor for fever, spreading redness or discharge
- Remove sutures on 20 November
Details to leave out
- Husband's night-shift job
- Sons in Leeds and Dubai
- Gardening and choir
- Smoking and alcohol status
- Appendicectomy in 1990
- Hypothyroidism and levothyroxine
- Hypertension and amlodipine
One good way to write this letter, not the only one. Written by Kurippu; awaiting nurse review.