Nursing · Referral letter · Task 2

Teaching a newly supplied inhaler device

You are a practice nurse at Northgate Surgery. Today is 24 September 2026. Using the case notes, write a referral letter to Ms Helen Ward, Respiratory Nurse Specialist, Northgate Clinic, 21 Birch Street, Fairford. Request device teaching and observed practice within one week. Write approximately 180-200 words in the body of your letter.

Patient: Rafiq Ahmed, born 6 June 1964

Case notes

• N01Patient: Rafiq Ahmed; reviewed 24 September; established respiratory condition under GP care; no new acute symptoms reported today.
• N02GP plan: prescribed replacement inhaler device after formulary change; medicine regimen recorded on attached prescription; nurse to arrange device education, not alter prescription.
• N03Observation: patient explains when to use medicines but cannot demonstrate the new device sequence; confuses preparation with inhalation step.
• N04Prior teaching: written manufacturer guide supplied 20 September; patient reads English but finds diagrams difficult; prefers demonstration followed by practice.
• N05Practical: works early shifts; available after 14:00; has device and spacer to bring; consent for referral given.
• N06Request: specialist teaching within one week; observe return demonstration and report remaining difficulties to GP.
• N07Follow-up: GP review 8 October; current plan remains unchanged pending review.
• N08Other: supports local football club; used old device for several years; recently changed mobile-phone case.