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Writing : 40 minutes

You are the nurse manager in the Wesley Hospital, Australia.

Name:                             Mr Gurdeep Singh

DOB:                              22/09/1965

Marital status:              married

Admission date:           06/08/17

Discharge date:            28/12/17

Diagnosis:                    Colostomy, prolapsed and infected stoma

Social background:     lives with wife, Fathima, and two children .currently works as an accountant, worried

about extended leave from work. Hobbies: gardening, swimming, chess.

Medical history:          2007: type 2 diabetes, hyperlipidemia
2009 -anxiety- sleep deprivation
2010- polyps -benign – excised, no complications
2016- colorectal cancer

Medications:                high fibre and low-sugar diet, atorvastatin -80mg daily, Daonil 15 mg, metformin


Management:             surgery to remove colorectal cancer 02/07/2017. Due to severe discomfort admitted

on 06/08/2017.diagnosed with prolapsed infected stoma. Two additional operations

during hospitalisation.

Assessment:                no stoma infection. Significant weight loss (110 kg on admission) 80 kg on discharge.

Patient can do ADL but worried about the job.

Discharge plan:          due to weight loss and multiple abdominal folds, colostomy bag, comes off often. Help

with changing the colostomy bag and monitor it daily. Monitor medication

compliance. Monitor for stoma infection. Continue for home visits for two weeks post-


Write a letter to Mr Mathew Harris, Outpatient stoma therapist at Prince Alexander Hospital, 456 Plat road, Australia, Vic 3245.



Mr Mathew Harris

Outpatient stoma therapist

Prince Alexander Hospital

456 Plat road

Vic 3245

Dear Mr Harris

Re: Mr Gurdeep Singh, DOB: 22/09/1965

I am writing to request home visits for two weeks to Mr Singh’s house for daily observation and management since he is recovering from prolapsed and infected stoma.

Mr Singh underwent a colostomy for colorectal cancer in 2016, and removal of colorectal cancer was performed on 02/07/2017.

After a month, Mr Singh was admitted to hospital due to definitive symptoms of the above-mentioned diagnosis. Whilst in hospital, two additional operations were performed, and he was received conservative management. His stoma is clear from infection, and he is being discharged today.

Mr Singh is an accountant who lives with his wife and two children. Even though he is capable of his activities of daily living, he found to be anxious regarding his job since his colostomy bag often come off owing to the significant weight loss and multiple abdominal folds.

As per the discharge plan, kindly monitor the health of stoma, and assist him in changing the colostomy bag daily.

Please feel free to contact me for further queries.

Yours Sincerely

Nurse manager
The Wesley Hospital



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