Have you ever failed something for the very first time in your life? Not struggled with it. Actually failed. Mine came at the worst possible moment, and it came down to how I wrote two bags of saline.
Fewer of Us Back Then
Of everything I went through on the way to becoming a UK registered nurse, nothing tested me the way the OSCE did. It’s the practical exam every overseas-trained nurse has to pass, and I spent more than two months preparing for it.
For a lot of Filipino nurses, this is the hardest hurdle in the entire process. Back when I sat it, there wasn’t much shared information to lean on. But I won’t use that as an excuse. Looking back, I personally feel I should have handled the time pressure a bit better.
These days, tips and feedback get passed around all the time, because so many overseas nurses have come to the UK since. Ten years ago it was a different story. In our trust, there had only been two overseas nurses before us. Then came our batch of three, and the batch after us was three as well. A few years later, before the COVID-19 pandemic, hospitals were taking in two to three dozen overseas nurses every few months. It hasn’t picked up to that level since.
Two Words on a Page
So we did what we could. Most of our days in that stretch were spent practising, running through scenarios and drilling the kind of precision the exam demanded. I took it seriously. I thought I was ready.
I failed.
The OSCE had two parts, and I only had to repeat the first one, which included the written documentation. That’s where it happened, and over something almost absurd in hindsight.
The space on the documentation form was so small that I squeezed my answer down to “2 x 1L 0.9% saline”, instead of writing it out properly as “two bags of one litre 0.9% saline”. (That’s a standard salt-water drip, the most common IV fluid there is.) Trying to cram everything into that tiny space probably didn’t do my handwriting any favours either. That shorthand cost me the exam.
The Lowest Point
I want to be honest about what that failure did to me, because I think it matters more than the OSCE itself.
It was the first exam I had ever failed in my entire life. Not the first exam I’d found hard. The first one I’d actually failed.
And this wasn’t some low-stakes retake situation. Failing a second time could have meant being sent back to the Philippines. I told my tatay exactly that, without softening it, because I felt he deserved the truth about where things stood.
Of my whole nursing career, that was the most depressing stretch, and I don’t say that lightly. The closest thing I can compare it to is the pain of ending a five-year relationship with someone I’d once thought I’d spend my life with.
I barely slept for days afterwards. Not because of the studying I still had ahead of me, but because of the shame. Plain and simple shame.
Round Two
My second attempt went completely differently. Smooth, controlled, none of the panic of the first round.
My friend Arsad showed up again, this time to offer moral support, not just to me but to the other nurses sitting the exam alongside me that day. He’d rented an Airbnb near the venue and invited me to stay there with him, so I wouldn’t have to spend extra on a place of my own. Maybe he sensed I needed the extra bit of steadiness after what I’d been through. It was a small gesture in the scheme of things, but it meant a great deal to someone in my position at the time.
Since the mistake that had cost me the first attempt was so small to begin with, I passed comfortably the second time around.
Why I Needed It
Here’s what I’ve come to understand about that period, though. I think I needed it.
I needed something to humble me, to remind me I was still human, still capable of getting something wrong despite how hard I’d worked.
Plenty of nurses fail an exam somewhere along the way, IELTS especially, more often than people admit out loud. I just hadn’t had my turn yet. When it came, it gave me a real taste of what that feels like from the inside, not just something I’d sympathised with from a distance when it happened to other people.
Once I’d recovered from it, I actually felt grateful, strange as that sounds, because it meant I could genuinely relate to people who’d been through the same thing instead of just nodding along.
I think part of it, too, was simply that I’m a perfectionist, and that’s a big reason the failure was so hard to accept. I wanted a clean slate, a spotless record with nothing ever going wrong. That was always a fantasy, never a realistic goal. And honestly, a life where you never fail at anything would be a boring one.
That exam taught me, properly taught me, that it’s okay to fail. And as cliché as it may sound, it doesn’t kill you. If anything, it makes you stronger. As the Bible puts it, “the righteous one may fall seven times, and he will get up again” (Proverbs 24:16).
Why I’m Telling You This
It takes a bit of courage to share something like this. Plenty of people would rather sweep it under the carpet and never mention it again. I get that.
But if you’re going through the same thing right now, I want you to know you’re not alone. You can do it again. You’ll get there eventually. And one day you’ll look back on this stretch and laugh about it, because it’s just a reminder that we’re human, and making mistakes is okay. As long as nobody gets hurt, of course.
And honestly, if you’re going to fail, this is the stage to do it. Better to make that mistake in an exam room than with a real patient once you’ve got your PIN. You won’t make it again. Learning from your mistakes sticks with you far more than learning from a textbook ever will.
Rules Are Rules
I know how it sounds when I lay it out like that. Failed over how I wrote two bags of saline. Some people might think it’s unfair, that a technicality like that shouldn’t be enough to fail someone who clearly knew what they were doing.
Others might point out that most hospitals now use computerised records and electronic medication charts, so a “wrong” handwritten note like mine would probably have no bearing in real life. Fair point. But back then, not many hospitals were using Epic (a widely used electronic health record system) or anything like it yet. Funnily enough, ours was. Addenbrooke’s went live with Epic in 2014, the first hospital in the UK to use it. But the OSCE doesn’t care what system your hospital runs. It is what it is.
And that’s exactly the lesson underneath it all. Here, the rule is applied exactly as written, with no room for the kind of small sympathy that might let something like that slide back home in the Philippines. Over there, someone might wave it off. Here, the rule is the rule, full stop.
I didn’t like it in the moment. I understand it now.
Why Small Mistakes Matter
And I’ll say this too, because it matters more than the story of the mistake itself.
What I did might sound like a simple, almost silly error: a few words squeezed down to fit a small box on a page. But in nursing, and in medicine generally, that kind of imprecise wording is exactly the sort of thing that can cause serious harm, or even kill someone. Clarity and accuracy in documentation aren’t a technicality. They’re the whole point.
Every Filipino nurse already knows that in theory. But put someone under real time pressure, where going even a single second over the limit fails you automatically, and the brain can glitch on something you’d never get wrong on an ordinary day.
That’s what I want people to understand. Not just that I made a small mistake, but why a mistake that small is taken so seriously in the first place.
But that failure showed me something else, too. Something I’d quietly let slip, without even noticing.
