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I don't remember exactly when I decided to become a nurse. As a child, my favorite toy was the medical bag. I strutted around, stethoscope around my neck, giving fake injections with a plastic hypodermic needle. But it was the movie "Fantastic Voyage" that sparked in me an insatiable curiosity about the human body - how it works, how it heals.

I've been a registered nurse for 14 years. In that time, I've seen patients at the beginning and end of their lives, in times of fear and times of joy. I have used my skills and knowledge to assess a patient's circulation, breathing and response to medications. I've changed dressings and transfused blood, and administered pain medication and tube feedings.

I've taught patients how to change their diet to manage high cholesterol and diabetes, and taught a new mother how to breast-feed her infant. I've held patients' hands as they are anesthetized for surgery.

One of the most challenging, but satisfying, aspects of nursing is the role of advocate. An advocate speaks for one who can't speak for himself, and in nursing this means listening to patients' health concerns and asking questions that the patient doesn't know how, doesn't know whom or doesn't know enough to ask.

A nurse advocates for the patient when he or she questions an order for medication that could interact with other medications, or tries to prevent the discharge of a patient who doesn't have the strength or resources to care for himself at home.

Recently, my nurse colleagues have been speaking up for patients by demanding safe health care with adequate staffing in our hospitals, but their cries are falling on deaf ears. Repeatedly we hear about the effect of the Balanced Budget Act of 1997 and the cuts in Medicare and Medicaid reimbursements.

The standard hospital response is to cut services and reduce patient-care staff, while retaining an expensive top-heavy administrative level. I'm saddened and angered by a health care system that continues to reduce staffing to dangerously low levels.

Friends and family tell me of their experiences in local hospitals. They tell of the call bell that rang for an hour before anyone responded to their request for pain medication, a basin to vomit in or assistance to the bathroom. One preson waited in the emergency room for 16 hours because there was no available bed in the hospital and no one to care for them once they got there.

When I ask if they voiced their complaints while they were hospitalized, the response is always the same: "I saw they were really busy and, besides, I didn't want to look like a troublemaker."

I'm amazed, because these same people will drive back to the grocery store when they've been overcharged for a dozen eggs or call the Better Business Bureau when they think they have been ripped off by the muffler shop. You have the right to safe hospital care, whether you have paid for it through private insurance, as a benefit of employment or as a taxpayer.

Unfortunately, today you must demand it. Ask to speak to a patient representative or hospital administrator if you feel you aren't getting the nursing care you need. Write a letter to your doctor or insurance company if you don't think you're getting what you paid for in the hospital. Phone your elected officials and ask what they are doing to support legislation that will return health care dollars to Western New York.

We are your nurses. We are your neighbors. And we need your help. We will continue to advocate for you, but our numbers are dwindling and our voices aren't being heard.

SUZANNE KOCIENIEWSKI, a registered nurse, lives in Kenmore.

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