Tristan Kate Smith (pictured left) was a former ER nurse in Dayton, Ohio.
A “devoted” nurse who committed suicide and left a note criticizing the US healthcare system epitomizes the crisis facing hospital workers, her devastated family said.
Tristan Kate Smith, who worked as a nurse in the emergency room of a hospital in Dayton, Ohio, died at home by suicide on August 7, 2023, at age 28.
Her family later found a letter she had written five months before her death on her laptop titled “A Letter to My Abuser,” where “abuser” refers to the American healthcare system.
In the note, Smith described the system as abusive and said the toxic work culture crushed her spirit.
She said she did not feel protected from violent patients or from making mistakes in her work.
Smith’s suicide comes as a report from the US Centers for Disease Control and Prevention (CDC) found record levels of burnout, harassment and desire to leave the field among healthcare workers.

One study found that healthcare workers have a higher risk of suicide compared to the general population, and specific roles are particularly at risk.

Ms Smith (centre) described the healthcare system as abusive and said the toxic work culture crushed her spirit.
The news follows a series of health care worker strikes over wages and working conditions, with 75,000 unionized Kaiser Permanente employees citing feelings of burnout and staff shortages as they staged strikes in five states and the District of Columbia.
In September of last year, the largest nursing strike in US history took place in Minnesota, where 15,000 nurses embarked on a three-day strike.
They said their hospitals had failed to recruit and retain adequate nurses, leading to staffing shortages that reduced the quality of care.
The nursing crisis is particularly acute in Minnesota due to its aging population, which is placing additional stress on hospital staff, along with a low statewide unemployment rate, with fewer incentives for people to join. to the profession.
The average registered nurse in Minnesota earns $84,030 a year, or an hourly wage of $40.40, making the state 13th in the country, according to Nurse Journal.
In California, registered nurses earn $124,000; Southern and Midwestern states pay the least, with Alabama nurses earning $61,000 a year.
Minnesota wasn’t the only state to strike: In Oregon, 7,000 health care workers were out of work, and in Hawaii and California, mental health professionals went on strike amid protests over staffing shortages.
And earlier this year in New York, more than 7,000 nurses at Mount Sinai, one of New York City’s largest health systems, went on strike.
The nurses are constantly called for “doing more with less,” Ms. Smith had written.
Research suggests that nurses are twice as likely to die by suicide as the general female population and 70 percent more likely than female physicians.
Ms. Smith’s letter was published in a local Ohio newspaper. The Oakwood Record this month, along with a letter from his father, Ron Smith.
Mr Smith wrote: ‘You are reading this now because Tristin’s story needs to be told. We need to take action. Our nation’s healthcare system is broken and that broke our girl.
‘Her passion for nursing has turned into a nightmare. Tristin was in trouble. The nurses are in trouble.
Referring to the health system in her letter, Ms. Smith said it “took my heart and slowly crushed the good in it.”
She said: ‘You asked my colleagues and me what we needed to help patients and improve satisfaction scores, and we told you the truth. But then you sent us to online courses that taught us to smile more and be friendlier to patients.
“That’s when I began to understand your true cruelty and manipulation.”
Casey Chosewood, director of the Office for Total Worker Health at the National Institute for Occupational Safety and Health, told CNN that employers should take the information from the CDC report and “take immediate preventive actions,” such as ensuring that employees are more involved in decision making.
He said: “Labeling our current and long-standing challenge as a ‘crisis’ is an understatement.”
In her letter, Ms Smith called her “abusive partner” “relentless” and detailed how “every day” she was asked to “do more with less.”
He said he had heard about nurses being hit by patients and how they were advised to “not fight back” and instead “stand with their hands up” and wait for security to arrive.
The CDC report found that the number of healthcare professionals who experienced harassment at work skyrocketed from six percent to 13 percent between 2018 and 2022.
Examples included violent threats, intimidation, and verbal abuse from patients and co-workers.
The data was from 226 healthcare workers in 2018 and 325 healthcare workers in 2022.
The report also found that bullying had a major impact on mental health. Nurses who said they had been harassed were five times more likely to report anxiety compared to those who had not, three times more likely to be depressed, and almost six times more likely to report burnout.
Mrs Smith wrote in her letter: “You beat me to the point that my body and mind are black, bruised and bleeding.”
And he added: “They use us and exploit us to line their pockets, using the common citizen’s money for overpriced health care.”
Ms. Smith made reference to nurses not being protected by the law or by their employers. Some believed this was a reference to RaDonda Vaught, a nurse who was convicted of manslaughter after her 75-year-old patient died when Ms. Vaught gave her the wrong medication.
“Caring for sick people can also be intensely stressful and emotional,” said Dr. Debra Houry, CDC medical director.
In the latest CDC survey, 44 percent of healthcare workers said they wanted to look for a new job, up from 33 percent in 2018.
In his obituary, his family said: ‘Tristin had a smile that lit up any room. She was brave, smart and beautiful. “She will be desperately missed by all those whose lives she touched.”