This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255).
Tristin Kate Smith, a 28-year-old Ohio nurse, wrote a scathing letter to her "abuser" five months ahead of her August 2023 suicide.
The letter has since gone viral among nurses across the country — many of whom share Smith’s disillusionment with the U.S. health care system.
"I so desperately want to continue to help people, but I cannot stay in this abusive relationship," wrote Smith, who worked as an emergency room nurse in Dayton, Ohio.
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Her father, Ron Smith, discovered the letter, titled "A Letter to My Abuser," on the nurse’s laptop two months after her death.
In October, it was published as a letter to the editor in The Oakwood Register, a local paper in Ohio, in an effort to raise awareness of how some nurses feel the system they serve is failing them.
Smith, the youngest of six children in her family, battled depression but reportedly never sought professional help.
"Those in the health care field may avoid talking about their mental health struggles for fear of jeopardizing their licensure and negatively impacting their ability to continue serving in their current roles," Dr. Lama Bazzi, a psychiatrist in private practice in New York City, told Fox News Digital in comments about the case and its wider ramifications.
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"It is vital to the survival of the health care field for workers to feel safe asking for help — and for help to be readily available to meet their needs before their mental health struggles rise to the level of suicidality," she added.
"We cannot continue to expect health care workers to suffer in silence when they are at risk for a tragic yet preventable cause of death."
In his own letter in The Oakwood Register, Smith’s father wrote that he now has "regret-filled hindsight" for not seeing the signs that his daughter was not OK.
She showered her "beloved" dog Calypso with "more dog enrichment toys and contraptions than a single pet store sells," her father wrote.
Smith had also posted affirmations and mantras throughout her home.
"She tried so hard to stay alive, but none of it was enough to stop the darkness," her father said in the letter.
"We — nurses and doctors — entered our professions with the noblest of ambitions: to help others who are hurting," Dr. Mikkael Sekeres, a wellness expert and chief of the division of hematology of Sylvester Cancer Center at the University of Miami, told Fox News Digital.
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"It’s difficult to do that when you hurt more than your patients do," he went on. "When this happens, people leave medicine, or worse."
In her letter, Smith stated that a shortage of nurses made her feel overwhelmed.
"Each day, you ask me to do more with less," she wrote.
In a statement to Fox News Digital, the American Nurses Association (ANA), headquartered in Maryland, said that the "negative emotions, mental health challenges and burnout" nurses are facing are "symptomatic of a broken health care system that far too often fails to provide nurses with continuous support and to address chronic work environment challenges."
Recently, over 75,000 unionized Kaiser Permanente employees across six states — many of whom were front-line support staff — staged the largest walkout of health care workers in U.S. history over concerns of staff shortages.
"National data about the state of nurses' mental health and well-being indicates that they are suffering mental anguish or toxic emotions, and combating stigma as a health care professional seeking help," the ANA added.
Smith’s letter also referenced that many nurses feel that hospital administrators are taking advantage of them.
"You are a narcissist," she wrote. "You use and exploit us to line your pockets, using the common citizen’s money for overpriced health care."
She called for more workplace safety and for nurses to not receive blame for being assaulted on the job.
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"I remember the first time I heard about nurses getting hit," she wrote.
"I remember that you asked them what they’d done — or didn’t do — to prevent it from happening."
A recent report from the Centers for Disease Control and Prevention (CDC) found that the number of health care practitioners experiencing workplace harassment, such as threats, bullying or verbal abuse from patients and coworkers, doubled between 2018 and 2022, leading to more anxiety, depression and burnout.
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"Studies show that health care workers are at a higher risk for suicide than the workers in other fields," Bazzi told Fox News Digital.
"Women are particularly vulnerable — differences in stress in workload, burnout and difficulty with work-life balance may all be implicated."
Nurses were 18% more likely to die from suicide than the general population between 2007 and 2018, according to a 2021 report that included data from the CDC and the National Violent Death Reporting System.
Female nurses were 70% more likely to die by suicide than female physicians, and twice as likely to die by suicide compared to the general population.
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"I would make the case that most health care workers feel the system is broken," Sekeres told Fox News Digital.
"Some still have the energy to take it on, and to create solutions to problems their patients face by being innovative with workarounds to systemic problems, while others have given up and feel helpless to be advocates for their patients," he added.
"It’s this learned helplessness that I believe is the greatest contributor to burnout in health care."
The ANA is calling for action.
"It's time to listen to nurses and make them a priority," the organization said.
"Without this action, we will lose more bright lives like nurse Tristin Kate Smith and many others."
