Tristin Kate Smith, an emergency room nurse, was 28 years old when she died by suicide in August. Five months prior, she wrote a letter comparing the healthcare industry to an abusive partner that has grown to resonate with exhausted clinicians across the country.
Ron Smith, Ms. Smith's father, found the letter on her laptop after her death and submitted it as a letter to the editor in the Oakwood Register, a local newspaper.
"Our nation's healthcare system is broken, and it broke our girl," Mr. Smith wrote in a foreword to his daughter's letter. "Her passion for nursing had turned into a nightmare. Tristin was in trouble."
The letter, titled "Letter to My Abuser," details Ms. Smith's experience working in the emergency room. She begins by stating that her interest in healthcare began at a young age, and described her subsequent devotion to studying and to her patients in the early days of her nursing career.
"I told you I would be there through the good and the bad, but you have taken my heart and slowly crushed the goodness it had," Ms. Smith wrote. "You love-bombed me with affection, and you told me I was going into a career that matters. I could make a difference."
Over time, the thank-you letters and compliments lost their meaning, and her concerns surrounding staffing levels and safety began to grow.
"In your eyes, these staff were 'unnecessary,' but it came at a high cost for the advertised 'quality care' provided to our patients by those of us who were left," Ms. Smith wrote. "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 just smile more and be friendlier to the patients. That's when I began to understand your true cruelty and manipulation."
The letter recalls an environment of fear and blame at the unnamed hospital, and Ms. Smith's concerns for her own safety amid rising patient violence. She wrote that she could now see beyond the pizza parties and free pens doled out to "healthcare heroes" in place of the love and support they needed.
"I so desperately want to continue to help people, but I cannot stay in this abusive relationship. Each day, you ask me to do more with less. You beat me to the point that my body and mind are black, bruised, and bleeding out," Ms. Smith wrote. "I'm only sorry to my patients and colleagues. You deserve so much better, but my abusive partner is relentless."
"If I stay, I will lose my sanity — and possibly my life — forever," the letter concludes.
The letter has gained national attention since its initial publication, sparking outrage among healthcare professionals and the general public alike. Nurses have taken to TikTok, X and media outlets to express their frustrations with unsafe working conditions, which are driving more and more clinicians away from the profession. When nurses finally call it quits, those who stay behind find themselves with an increased burden, and the vicious cycle continues — often leaving young nurses like Ms. Smith to handle situations on their own.
"So they're afraid of making mistakes. They're afraid to lose their licenses. They are afraid of killing somebody," Taccara Durrett, RN, a nurse since 2009, told USA Today. "This is the worst that I've ever seen healthcare and nurses are so stressed and burnt out. This is crazy, and no one is listening to us."
Mr. Smith recalls his daughter as an "upbeat and confident" person, with a love for animals (including her cat Sphinx and dog Calypso); a green thumb; and a knack for baking, writing and the arts. She made a significant impact on her friends and patients alike.
"Some people go into nursing for many different reasons, but this was a calling for Tristin," Mr. Smith told USA Today. "She loved caring for people."