Emergency Room Nurse, Lost to Suicide, Called US Health Care System Her ‘Abuser’ in Haunting Letter

Tristin Kate Smith’s tragic death sheds light on the challenges faced by nurses and the urgent need for change in the healthcare system.

The heart-wrenching story of Tristin Kate Smith, a 28-year-old emergency room nurse from Dayton, Ohio, has captivated the nation. After taking her own life on August 7, 2021, Smith’s brutally honest letter, in which she referred to the U.S. health care system as her “abuser,” went viral among nurses across the country. The devastating loss of a dedicated healthcare professional has sparked a conversation about the challenges faced by nurses and the urgent need for reform in the healthcare system.

Remembering Tristin Kate Smith

Family members and friends of Tristin Kate Smith have shared their memories of her, painting a picture of a compassionate and kind-hearted individual. Sarah Smith, Tristin’s older sister, recalls the countless little moments they shared, which showcased their deep bond. Daye Smith, another older sister, fondly remembers Tristin as her best friend, with an unspoken understanding between them. Kristin Butler, a close friend, emphasizes Tristin’s immense kindness, loyalty, and ability to find humor even in difficult situations.

The Crisis in Nursing

Tristin Kate Smith’s tragic death has reignited discussions about the challenges faced by nurses in the healthcare system. Erica, a national nurse advocate and social media influencer, highlights that the nursing crisis is not solely due to a shortage of nurses but rather the unsustainable conditions they face. Evidence-based research indicates that for every additional patient a nurse is forced to care for, there is a 7% to 10% increased risk of death or serious complications for all patients under their care. This statistic underscores the urgent need for change.

Mandating Nurse-Patient Ratios

California is currently the only state that has mandated nurse-patient ratios, while Oregon has passed legislation that will go into effect next year. The of federal legislation, known as The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act, aims to establish nurse-to-patient staffing ratios nationwide. However, despite being reintroduced annually for the past 15 years, the U.S. Senate has failed to hold a vote on the bill. Advocates argue that mandated ratios have proven to improve nurse retention rates and patient outcomes, as demonstrated by over 20 years of data from California.

Ensuring Safe Working Conditions

Nurses should not live in constant fear of retaliation for speaking up about patient safety concerns. Health care organizations must be required to provide safe working conditions and prioritize the elimination of violence against health care workers. Many facilities lack basic security measures, such as metal detectors and armed security, leaving nurses vulnerable to potential harm. By implementing comprehensive security measures, health care facilities can create a safer environment for both patients and staff.

Addressing Burnout and Mental Health

The issue of burnout extends beyond nurses to include doctors as well. Studies show that 86% of doctors suffer from burnout, with decreasing administrative burdens and improving clinical caseloads cited as effective measures to reduce burnout. Mental health resources should be readily available to all health care workers, providing ongoing support rather than just a one-time hotline. Peer and administrative support, access to therapists, and regular check-ins can help alleviate the mental health challenges faced by medical professionals.


Tristin Kate Smith’s tragic death has shed light on the challenges faced by nurses in the U.S. health care system. The urgent need for change is evident, from mandating nurse-patient ratios to ensuring safe working conditions and addressing burnout and mental health. The American Nurses Association calls for meaningful action at the legislative and institutional levels to transform unhealthy work environments and provide continuous support to nurses. Without these changes, more lives like Tristin’s will be lost, leaving a devastating impact on the healthcare profession and the patients they serve.






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