REGISTRATION ROAD – CONCLUSION

Ten days ago I re-sat the OSCE, the final exam to garner UK nursing registration. I had no idea if I passed. In fact, if you were to ask me, gun to my head, I would have told you I failed. I don’t like this kind of pessimism, and consider myself an optimist, but the delay-riddled road towards nursing registration changed me in a lot of ways, and, when it came to this, I was not so naive as to presume anything.

It has been nineteen months since I begun the paperwork necessary for getting myself registered in the UK. Back then, I was full of adrenaline and a dogged enthusiasm. I had been warned by many parties that it was a trial for an Australian nurse to work in England, but I surveyed the mountain I’d put in front of myself and decided that, as long as I kept walking, I could scale it.

This attitude worked for a year. A year is a long time to work towards something. In retrospect, it doesn’t sound so bad, but for three-hundred and sixty-five long days I thought about and put energy and effort into achieving this goal. That means from the outset, I awoke three-hundred and sixty-five times and resolutely pointed myself back up that mountainside. And in case you haven’t done it, it’s damn exhausting to walk uphill.

Which is exactly how it felt. Every step I took came at a great expense of physical and mental energy. Nothing was simple and straight-forward. If I had seen the logic behind the things I was doing, the documents I had to gather at personal cost, and the exams I had to sit, also at a high personal cost, then it would have eased the journey, I would have seen my destination getting closer and known that what I was doing was effective. Instead, everything I was asked to do led me around in circles, often having to repeat steps I’d already taken, like police checks, immunisations, blood tests, GP declarations of good health, and forcing more and more detailed paperwork out of my university. It wasn’t a matter of ticking boxes, it was ticking all the boxes, then going back and ticking them again and again as you watched your mark fade from the page.

Anybody who’s had a job that feels endless, who does all their work and finds the same amount or more waiting for them the next day can appreciate how this taps your motivation. It worms into that part of the brain that says to keep going and riddles it with holes. Defeatist thoughts begin to intrude, until you feel like laughing at the efforts you make while the out-box is consistently outweighed by the in-box.

This was me after a year, sitting and laughing and shaking my head when the latest report came online in my UK registration portal telling me the documents I’d already acquired needed to be reacquired, with no explanation as to why the previous version had been deemed insufficient. I was watching the ticks fade from the boxes, and it got to me.

My view of the world has always been one of hard work winning out. Not that every hard worker somehow becomes a millionaire, more that input results in an equal output. I had seen my parents work and save for their whole adult life, but the victories seemed to match up with the sacrifices they made. We had a home, and food, all the possessions we’d ever need, and the ability to go away in the summer and relax with family and friends. They worked, yes, but the payout of that hard work seemed justified.

For the first time in my life, hard-work added up to jack-shit.

But, slowly and resolutely, clinging more to an insane refusal to break than any real hope that I would achieve my original goal, I persevered, and eventually those boxes, now scarred and marked with repeated ticks, remained filled. It had taken sixteen months, a lot of money, and a huge chunk of my energy, but I finally only had one last box to check. Of course, it wasn’t this simple.

This last box cost money. A lot of money. I was to be tested, despite the testing that had already taken place when I completed all my placements, graduated from university, and successfully obtained, held, and was even promoted in my employment. I was to be held to their standards. This bothered me, mostly because I felt I had done more than could be reasonably asked from a person, but the logic of it was clear. What wasn’t clear was the obscure way they went about laying out the exam, feeding those to be examined scraps until the whole procedure became one stained with doubt and confusion, which led invariably to stress. This seemed so unnecessary, and not an accurate way to examine anyone. Shouldn’t we be taught first, and then be tested on what we’ve learnt? Instead, they seemed ready to test, and then tell you where you went wrong. This meant failing, and paying the huge sum of money just to find out one piece of information, one lesson, and then having to try, and pay, again. It seemed backwards, and horrible, and exactly like every other part of the registration process. I don’t know why I was still surprised at this point.

I sat the exam, and failed.

In the wound care station, I picked up a cotton ball from my sterile field with the same hand I used to clean the patient’s wound. It didn’t matter that I was wearing sterile gloves, that all those sterile gloves had touched was a sterile cotton ball soaked in sterile saline, I had reintroduced something into the sterile field that had left the sterile field, and this was deemed sufficient to endanger the patent’s wound to infection. While I can see the minute chance that this would have at creating an infection in a wound, and while I can agree that they should tell me not to do this in the future, it bothered me that this was enough for them to fail me. And by “bothered me,” I of course mean it almost brought me to tears of rage and utter frustration.

I had played their game, done the hard work, and this infinitesimally small excuse was enough to, once again, set me back.

Something changed inside me with this failure. I felt defeated. I felt that I had been beaten, and knew I couldn’t keep stepping back up and trying again because eventually I would go broke in the attempt. I knew what I had done wrong and would not make the same mistake twice, but part of me knew they’d just get me on another small hitch that would see me fail again and again.

Despite this, hanging onto the last threads of refusing to be broken, I signed up, paid the money, and rescheduled a resit of the exam. I didn’t think I could pass, but had come so far up the mountainside it seemed there was no way to go back down.

Ten days ago I resat the exam, and passed.

I was, unsurprisingly, pleased. Okay, I was fucking ecstatic. But also, more so, the dominating emotion was relief. Upon reading the email congratulating me, the weight and stress that had dragged at my shoulders for a year and a half suddenly lifted, and I could have collapsed as mental muscles released. It was done. I did it. I hadn’t been beaten.
And this seemed the greater accomplishment. Not the fact that I could now practice as a nurse again, not the easing of financial stress this fact resulted in, but that I hadn’t been broken. That I had kept scaling the mountain despite what felt like endless pitfalls and active opposition, and I achieved what I set out to do. That lesson, that reaffirmation of the belief that perseverance will win out, was the sweetest victory I took away in that moment. That was the win.

And it was communal win, because in no way did I accomplish it alone. Without my community around me, I would have buckled. I am infinitely grateful to all the people who supported me in my efforts to beat this beast. I have had nothing but support, encouragement, praise, assistance, and love from my friends and family. I am humbled by the people who have bothered to take the time to give me their time and kind words. That I have come this far is because they have held my hand and pulled me up each step of the way.

I have had countless conversations with friends about the madness of the registration procedure and they have all sympathised and empathised with me. My current housemates, Dom and Nikki, shared a lot of the same ill-logic England presented to me, and their mutual understanding helped tremendously.

My family supported me from the outset, knowing that a victory in this arena would ultimately mean time spent away from them. They didn’t hesitate for a moment in filling me with encouragement and pride.

My brother and best friend, Damian, for whom this absence would affect the most, actively bolstered my motivation every time it flagged. I lived with him and his girlfriend, and my friend, Holly, for six months before leaving Australia, and they patiently let me talk through every delay and frustration that tripped me up along the way.

And most recently, Alex, who showered me in unfailing love and support, and kept me together when the first failing of the exam threatened to have me fall to pieces. Her perspective of me gave me the drive to sit the exam again when my own perspective of myself left me devoid of incentive. Her own determination and tenacity is a constant inspiration, and I am blessed to have her in my life. I simply cannot thank her enough.

So this was a win. A win for me, and for my community. It took a lot from me, and scoured away some of the naive optimistic from my personality. It had me doubt my world-view, and face a society stripped of the beliefs I used to navigate life. But ultimately it proved that some things are true, and no matter how hard and exhausting the climb, it is possible to scale a mountain.

That persistence can win out.

Thank god it’s over.

REGISTRATION ROAD – PART 2

…my documents were rejected.

Not all of them, to be fair, but enough to delay me considerably. The document the university drafted for me apparently wasn’t detailed enough, so I had to get back in contact with the incredibly generous staff member who’d helped me previously and beg her to give a little more. She was a lecturer, and class had started by this point, so it was a further two months before she got back to me. Given that I was the one asking the favour, I figured it was rude to harass her.

My declaration of good health was rejected on the basis that I hadn’t been seen by the GP who assessed me in the previous six months. Of course I hadn’t — I’m in good health and have no need to regularly see a doctor. That was the whole point of the declaration. This line of reasoning was lost on them.
They also took issue with the fact that I hadn’t any experience in the field of midwifery. When I rang and explained that was because I am a nurse and not a midwife, the confused adolescent at the other end of the phone responded with: “Oh yeah, that’s tricky.” Tricky isn’t the word I’d use.
Round two: I eventually liaised with the contact at my university and she provided me with a second, more detailed, document. After all this, I wouldn’t be surprised if how regularly I went to the toilet at uni was listed in the document. I got checked over by another doctor and was once again deemed to be fit of mind and body to work as a nurse. And I had my current employer complete a document stating I had some experience in the world of midwifery. Which isn’t a complete lie — I had cared for two pregnant women in my career. My thanks go out to those two woman for allowing me to honest when checking that particular box on the endless requirement list.
Round two was sent off and I waited once again. I was told it could take up to three months for them to process my documents and get back to me. Three months after I’d already waited ten. By this point I had rented out my house and moved back in with my brother and his girlfriend in preparation for my overseas relocation in what was meant to be a very temporary situation. Luckily for me, they were unfailingly patient as I continued to reside in their home, month after month.
This was getting ridiculous. I had mentally made the move to the UK a year ago and that I was still in Australia was starting to grate, on principle alone. Plans I’d made to meet up with people overseas were falling through as I pushed my timeline back, and back again. So after talking it over with my brother, I decided to make the move before hearing back about my documents. I had provided them with every form, identification, history — personal, work, health, love life — that they had asked for, and I didn’t want to kill three more months that could be used for relocating. (Okay, not love life. That form wasn’t mandatory). So, fuck it. I bought my ticket.
And life was grand. I travelled through Italy with my cousin and his girlfriend, my soon-to-be roommates, and finally begun the trip I have envisioned a year ago. After three weeks of explore Italy, the three of us made our way to London, to our new home, and I picked up the task once more of battling for registration.
By this point it had been three and a half months since mailing off round two and I had yet to get an email confirming that my documentation was complete. Needless to say, I was a trifle nervous. I contacted them, waiting on-hold for half-an-hour before getting another juvenile young man who sounded as if he’d started work only the week before judging by the helpfulness of his answers.
I asked him why it was taking so long for my documents to be processed and when I could expect a response. He said he couldn’t access my account and so had no way of knowing. I asked why, when he worked for the organisation that managed the account, he couldn’t access it. He said that was how it worked, and seemed to think this was a completely satisfactory answer. I asked him if I was ever going to get a response, or had the organisation lost my paperwork, forcing me to attempt to gather the documents once again, a process that had taken me months to arrange. He suggested I wait one more week and see how I go. I asked if he really though one more week was really going to make a difference. He said it was worth a shot.
He was blowing me off.
But I couldn’t care. I was in London for only one week before jetting of to Austria for two weeks followed by two weeks in Greece, and registration stress could wait post-holiday.
A week later, in Austria, I received an email saying my paperwork had been received and to now wait for the outcome of the processing. Even though this was good news, I was kind of annoyed the vague and apathetic adolescent had been right.
It wasn’t until I was back in London that I received another email. They’d processed my paperwork. And according to them, things were outstanding. 1) The document from my university, and, 2) A declaration of good health. I fought the urge to cry from frustration.
I immediately contacted my helper from the university asking she resend the document, only to get an automated out-of-office email saying she was on long-service leave. Until December. At this point, it was September, meaning I wouldn’t get registered until at least the next year.
This was the lowest I’d felt during the whole process. To begin with, I’d met each hurdle with grinning gritted teeth, determined and resolved that, as long as I played the game, I’d win out. But over the months I’d felt my metaphorical back bend, and with each needless delay my resolve had warped and twisted into a cynical continuance, a plodding one foot in front of the other, more out of habit than the enthusiasm I had started with.
An old colleague of mine once told me not to let the bastards win. The bastards being anyone or anything that tries to beat you down. This expression has stuck with me during the years, and every time I felt like David in front of Goliath, completely dwarfed by the weight of stress or disappointment or expectation, I reminded myself of it. With this mantra in my head I straightened my metaphorical back, grinned my gritted teeth, and emailed the university asking if there was anyone else who could assist me while my contact was on long-service leave. Thankfully, they responded.
They couldn’t draft any new documents for me, but luckily they were able to assess the documentation that had already be created. They sent me a copy, and, reassured that the file did indeed exist and had been sent to the UK, I went about defending this position.
A phone call, a half-hour wait on-hold, and I was speaking to another person who was ready to dismiss my issue. I wasn’t having it. I insisted that all documents had been provided and if there was any issues, it was at their end. I detailed all that I had done, explaining that my university contact was on leave, that I had been doing this for a year now and I wasn’t going to be deterred. After a grumpy sigh like I was asking them to do more than their job, I was transferred to the correct department. They didn’t answer. When I bounced back to the original staff member they said I should try again in a few hours. I said I would’t do that, that every time I called I was on-hold for thirty minutes, and politely requested that they called me. She sulkily agreed. They never called me back.
Three days later I rang back and had a repeat of the same conversation. Again, the department I needed wasn’t available, but I the worker I spoke to this time was more proactive and promised they’d get in contact with me by the end of the day. I was skeptical, but two hours and forty minutes later, my phone rang.
I pleaded my case for the third time, this time to the right department, asking that, given that two documents from my university had already been sent, couldn’t I simply send the electronic copy I had to them? She was empathetic (or as empathetic as the organisation was capable of being, by which I mean she listened), but insisted that all documents had to be originals. She made me one allowance: If my university sent the same document I had to them, they would accept it.
Despite the fact that the electronic document was literally the same collections of 0s and 1s regardless of whether it came from me or my university, I didn’t argue, I thanked her and said she’d have it by the end of the week.
My new contact at the university was as confused as I was, but pleasantly agreed to send the form on. Her pleasantness may have come from the fact that my email to her practically dripped with platitudes and words of praise.
Meanwhile, I went about obtaining a NHS number, giving more forms of identification and proofs of address, so that I could see an English GP and get a third declaration of good health. If nothing else, it was validating to have three practitioners deem me mentally and physically sufficient.
This form was mailed off, I waited two days, and emailed asking if all documents had been received. She responded saying she’d look into it later that day.
That afternoon I got an email saying all paperwork had been cleared and I was free to book in the final exam. The final hurdle between me and registration. I was mildly pleased with this news. I’m pretty sure I literally clicked my heels at one point.
The final exam. It was a practical exam, meaning I have to physical demonstrate some aspects of nursing. This I knew, and was rather confident about. I think after six years working as a nurse, I’ve got my practical skills down. What rocked me, what I didn’t anticipate was the price tag that came with the exam. For the honour and privilege of sitting a one hour exam, I paid a grand sum of £1000. Roughly, $2200 Australian.
I knew there would be a cost associated with the exam, mostly because they had taken money from me at every juncture, why should this would be any different, but I didn’t realise it would be so much. But what could I do? I had come this far, and the wage difference working as a nurse as opposed to working a health care assistant as I was presently doing, was substantial. If I had any hope of recouping my loses due to the registration venture, it was through becoming registered.
I paid the money. It hurt.
And, at the time of writing this, I now have exactly one week until I sit the exam. The 23rd of December. An early Christmas present to myself.
I don’t think I’ve been more nervous about an exam. Not because I feel underprepared, but because I’ve never gambled $2200 on my own wits before. It adds a certain spice to the process.

So that has been my project for the past fifteen months. In between working, moving out of my house and into my brother’s, and eventually moving to London, I have been chipping away at a mountain at times I doubted I could level. One boulder now stands in my way.

Wish me luck.