Nursing — Transfer to Cardiac Rehabilitation after a Heart Attack
A cardiac ward nurse transfers a 56-year-old man to the cardiac rehabilitation nurse following a non-ST-elevation myocardial infarction and drug-eluting stent. The transfer letter must hand over the functional and psychological baseline, the medication changes, and the cardiac rehab priorities — the rehabilitation nurse must be able to plan the programme from this letter.
Letter type
Transfer
Write to
Cardiac Rehabilitation Nurse
Target length
180–200 words
The case notes
Patient: Mr Carlos Rivera, 56 years old, warehouse manager
Admission: 6-day admission following NSTEMI; drug-eluting stent to LAD artery (day 2); uncomplicated
Discharge status: Pain-free since day 2; mobilising freely on the ward; no signs of heart failure; discharged home
Medications: Aspirin 75 mg OD, ticagrelor 90 mg BD (12 months), atorvastatin 80 mg ON, bisoprolol 2.5 mg OD, ramipril 2.5 mg OD; no previous cardiac medication
Risk factors: Hypertension, BMI 33, ex-smoker (stopped on admission), previously sedentary
Psychological: Anxious about returning to work; tearful on day 4; seen by ward psychologist — one session, referral for ongoing support placed
Functional: No symptoms at rest; SOB on stairs (2 flights) at discharge; low exercise tolerance at baseline
Patient education: Dual antiplatelet importance explained; driving restriction (4 weeks post-stent) discussed; sexual activity advice given
Cardiology review: 6-week outpatient review booked; GP to check renal/electrolytes in 2 weeks
Task: Write a transfer letter to the cardiac rehabilitation nurse outlining Mr Rivera's current status, psychological needs, and rehabilitation priorities.
Writing task
Write a transfer letter to the cardiac rehabilitation nurse outlining Mr Rivera's current status, psychological needs, and rehabilitation priorities.
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
-
The psychological distress and that ongoing support has been referred
Anxiety after an MI is a rehabilitation priority that the cardiac rehab nurse must address from session one. The referral already placed means they need to coordinate, not initiate.
-
The functional baseline at discharge: SOB on stairs, low prior exercise tolerance
The rehabilitation programme must start from where the patient actually is. A baseline that is better than reality leads to an over-ambitious programme and a setback.
-
Dual antiplatelet therapy and its 12-month duration
The cardiac rehab nurse provides ongoing education. Knowing the patient has been counselled — and that ticagrelor runs for 12 months — allows them to reinforce rather than re-explain.
Leave out
-
The minute detail of the LAD stent procedure
The rehabilitation nurse needs to know the event and the functional outcome; the interventional cardiology record covers the procedure. A one-line summary is enough.
-
The GP follow-up and renal monitoring
A GP-facing action, not a cardiac rehab action. Include it in the GP discharge letter; it does not belong here.
Criterion in focus · Content
Transfer letters to specialist rehabilitation nurses are graded on whether the recipient can design the first session from the letter. The functional baseline (where to start), the psychological status (what to watch for), and the medication education (what to reinforce) are the three Content priorities. A letter that is all about the cardiac event and nothing about the rehabilitation needs fails this criterion.
Now write the letter — and find out what is blocking your Grade B
Write a 180–200 words transfer 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.