Tristan Kate Smith (pictured left) was a former ER nurse in Dayton, Ohio
A ‘dedicated’ nurse who killed herself and left a note criticizing America’s healthcare system epitomizes the crisis facing hospital workers, her devastated family says.
Tristan Kate Smith, who worked as a nurse in a hospital emergency room in Dayton, Ohio, died by suicide at her home on August 7, 2023, at the age of 28.
Her family later found on her laptop a letter she had written five months before her death, titled “A Letter to My Abuser,” where “abuser” referred to the U.S. health care system.
In the note, Ms Smith described the system as abusive and said the toxic work culture crushed her spirit.
She said she felt neither protected from violent patients nor from making mistakes in her work.
Ms Smith’s suicide comes as a report from the US Centers for Disease Control and Prevention (CDC) found record levels of burnout, harassment and a desire to leave the field among healthcare workers.
Healthcare workers are at greater risk of suicide compared to the general population, a study finds, with specific roles at particular risk
Ms Smith (centre) described the healthcare system as abusive and said the toxic work culture crushed her spirit
The news follows a slew of strikes by healthcare workers over pay and working conditions, with 75,000 unionized Kaiser Permanente employees citing feelings of burnout and staff shortages as they staged a strike in five states and the District of Columbia.
Last September, the largest nursing strike in American history took place in Minnesota, where 15,000 nurses began a three-day strike.
They said their hospitals had failed to hire and retain enough nurses, creating staff shortages that reduced the quality of care.
The nursing crisis is particularly dire in Minnesota because of an aging population, which puts additional pressure on hospital workers — coupled with a low unemployment rate across the state, with fewer incentives for people to enter the profession.
The average registered nurse in Minnesota earns $84,030 per year, or an hourly salary of $40.40 — ranking the state 13th in the nation, according to Nurse Journal.
In California, registered nurses earn $124,000; Southern and Midwestern states pay the least, while nurses in Alabama earn $61,000 per year.
Minnesota wasn’t the only state with strike action: In Oregon, 7,000 health care workers lost their jobs, and in Hawaii and California, mental health professionals went on strike amid protests over inadequate staffing.
And earlier this year in New York, more than 7,000 nurses from Mount Sinai, one of the largest health care systems in New York City, went on strike.
Nurses are constantly busy asked to “do more with less,” Ms. Smith had written.
Research shows that female nurses are twice as likely to die by suicide than the general female population and 70 percent more likely than female physicians.
Mrs. Smith’s letter was published in a local newspaper in Ohio The Oakwood Register this month, alongside a letter from her father, Ron Smith.
Mr Smith wrote: ‘You are reading this now because Tristin’s story needs to be told. We must take action. Our country’s healthcare system is broken, and it has destroyed our girl.
‘Her passion for nursing has turned into a nightmare. Tristin was in trouble. Nurses are in trouble.”
In her letter, Ms. Smith took aim at the health care system, saying it had “captured my heart and slowly crushed its good qualities.”
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 simply smile more and be friendlier to patients.
“That’s when I began to understand your true cruelty and manipulation.”
Casey Chosewood, director of the National Institute for Occupational Safety and Health’s Office for Total Worker Health, told CNN that employers should take the information from the CDC report and “immediately take preventative measures,” such as ensuring workers are more involved in the decision-making.
He said: ‘To call our current and long-standing challenge a ‘crisis’ is an understatement.’
In her letter, Ms Smith called her ‘abusive partner’ ‘ruthless’ and explained how ‘every day’ she was asked to ‘do more with less’.
She said she heard about nurses being hit by patients and how they were advised “not to fight back” and instead to “lay down with their hands up” and wait for safety.
The CDC report shows that the number of health care providers experiencing workplace harassment increased from six percent to 13 percent between 2018 and 2022.
Examples included violent threats, bullying and verbal abuse by patients and colleagues.
The data came from 226 health workers in 2018 and 325 health workers in 2022.
The report also shows that harassment has a major impact on mental health. Nurses who said they were harassed were five times more likely to report anxiety than those who were not, three times more likely to become depressed and almost six times as likely to report burnout.
Mrs Smith wrote in her letter: ‘You have beaten me so that my body and mind are black, bruised and bleeding.’
She added: “You use and exploit us to line your pockets, using ordinary people’s money for overpriced healthcare.”
Ms Smith referred 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 found guilty of murder after her 75-year-old patient died when Mrs. Vaught administered the wrong drug.
“Caring for sick people can also be intensely stressful and emotional,” said Dr. Debra Houry, chief medical officer of the CDC.
In the CDC’s latest survey, 44 percent of healthcare workers said they wanted to look for a new job — up from 33 percent in 2018.
In her obituary, her family said, “Tristin had a smile that lit up any room. She was brave, smart and beautiful. She will be desperately missed by all whose lives she touched.”