A s much as I sometimes hate to admit it, I am getting older. Fifty is fast approaching and I am finding out that getting older is not for wimps. Welcome to the baby boomer generation. The majority of nurses are baby boomers. Many of us will be leaving the profession in the next decade for a variety of reasons. For example:

* The nursing shortage.

* As we age, certain job requirements (such as lifting or transferring patients) becomes more physically demanding.

* Many want to retire to pursue other activities or change professions.

* Many will decrease the number of hours they are available to work.

However, many of us will continue to work, at least part-time, because we enjoy our profession and we like working with patients. Others, while they like to care for patients, may choose to continue working simply for the health insurance and prescription medication benefits.

Congress recently passed a prescription drug benefit package for senior citizens that will become effective in a few years. Prescription drug benefits for seniors have been a great catchall phase for politicians, particularly during election years. While I appreciate the efforts of Congress to start the process, I hope this particular piece of legislation is only the start of a better plan. Many senior citizens will not benefit from this legislation, and many will lose. I have read the bill several times and still find it confusing. I can only imagine how much of it the elderly can truly understand. Can Congress write anything in easy-to-understand English?

I sincerely hope Congress continues to work at making prescription medications more affordable and doesn't stop with this particular bill. However, Congress cannot do it alone. Pharmaceutical companies must also share in the burden of the cost of prescription medications.

I conducted an informal survey of Medicare recipients I know. Each person said this particular bill would cost them more now than they already pay for their prescription medications. Many would still prefer to acquire their medications from other countries (such as Canada, Mexico, and other countries). Others hope Congress will continue its efforts to control the costs of prescription medications so they are affordable. Many of us, fast approaching the age of Medicare, worry about the costs of our medications. We know that as we age we are likely to develop health problems that will require the use of daily or as-needed medications. When we reach retirement age, we will be living on a fixed income and may be without pension-provided prescription drug coverage. Many are looking ahead to see what their medications will cost at retirement age. It is not a pretty picture.

Our elderly citizens sometimes have to choose between food, housing, and medications. This is one reason the cost of healthcare is rising. People wait until they are truly ill before seeking healthcare. When this occurs, the costs are higher.

Another factor in this equation is that some senior citizens take less than the prescribed dosage to extend the medication. This also leads to the rising cost of health-care because these patients may wait longer before seeking care and are treating their current health care problems inadequately. Is this in our future? I sincerely hope not. We must take action today to remedy this nationwide dilemma.

We live in financially chaotic times. The stock market fluctuates up and down. Pension plans are disappearing or not earning what was expected. We did not become nurses to be rich. However, we do want to make a decent living while we are working and after we retire. We particularly want assistance with prescription drug coverage after we retire. We will develop health problems as we age (some of us have them now) and we worry about the cost of our prescriptions. What type of Medicare coverage will we have to help with the cost of our medications after we've retired?

So what can we do now? Stay in contact with your legislative representatives. Lobby for more comprehensive coverage for healthcare and prescription medications. Ask your representatives to explain their bills in layman terms. Tell your representatives in Congress that the current plan is a start but that it's not even close to what it should be. Tell them to keep the momentum going and not just work on a prescription medication plan during an election year. We have to work now to improve the bill just passed. We have to work now to make these medications affordable for all citizens. Thank them for their current efforts, but let them know the work is far from completed. The current bill will cost some senior citizens even more than they already pay. Congress must continually work to revise this bill until we have a plan that works for all citizens. Work with political action groups to make the bill less complicated and more affordable for senior citizens. On a personal basis, seek help with your finances for the future. Work with a financial planner to ensure you have the funds you will need and want when you retire.

Also, write to and speak with pharmaceutical representatives and ask that they cooperate with price controls. The costs of some medications in the United States is more than twice of that in other countries-for the same medications. Why? Work with your pharmaceutical representatives to discuss price controls. Learn who you should talk to now about this problem and then do it. Let the pharmaceutical companies know you are concerned about the costs of prescription medications and ask them what you can do to help reduce this cost.

Remember, we all will be senior citizens one day (some of us sooner, rather than later). Let's work to make healthcare and prescription drug costs affordable now and for our future. Work with the legislature, political action groups, and pharmaceutical companies to control these ever-increasing costs now. More legislation is desperately needed. If you are not already politically active, start small. Start with a letter to your representative. Also, feel free to write the pharmaceutical companies. A grass roots effort is necessary to ensure healthcare for our patients and us. Work with a financial planner for your retirement. As nurses, we have worked hard during our careers. We should be able to enjoy our retirement without worrying about whether to choose between food and housing or healthcare and medications.

Vickie A. Miracle, RN, EdD, CCRN, CCNS, CCRC