Hi Moona
As a RN , I share your burden. Like you, I struggled with TSE for a long time. I took that test nearly 4 times. I could not got more than 45 on each 4 exams. As a last hope I finally tried IELTS and passed at the first exam and got my visa screen certificate. I strongly suggest you, you should take IELTS. Do not waste your time with TSE. My first 485 application was denied in 2004 because at that time I was not able to submit visascreen and then following week of denial I applied for my new 485. Now I am waiting my approval. I have other nurse friends who are in the same boat with you because they can not pass TSE, they are trying IELTS as a last hope. I say last hope because they got their rfe recently and their lawyer told them if they can not submit visascreen in 3 months, they would be DEPORTED, and they only can apply to greencard in their home country. USCIS is changing procedure over and over again.