Judith Brown Davis v. Allen Parish Service District, doing business as Hospital of Allen Parish;

* Pursuant to 5TH CIR. R. 47.5, the court has determined
that this opinion should not be published and is not precedent
except under the limited circumstances set forth in 5TH CIR. R.
47.5.4.
United States Court of Appeals
Fifth Circuit
F I L E D
December 18, 2006
Charles R. Fulbruge III
Clerk
IN THE UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT
No. 06-30017
JUDITH BROWN DAVIS
Plaintiff - Appellant
v.
ALLEN PARISH SERVICE DISTRICT, doing business as Hospital of
Allen Parish; ET Al
Defendants
ALLEN PARISH SERVICE DISTRICT, doing business as Hospital of
Allen Parish
Defendant - Appellee
Appeal from the United States District Court
for the Western District of Louisiana, Lake Charles
No. 2:04-CV-938
Before KING, BENAVIDES, and CLEMENT, Circuit Judges.
PER CURIAM:*
Plaintiff-appellant Judith Brown Davis filed a suit under 42
U.S.C. § 1983 against her former employer, defendant-appellee
Allen Parish Service District, alleging, inter alia, that she was
terminated in violation of her right to free speech under the

-- 1 of 22 --

2
First Amendment and the Louisiana Constitution, Article 1, § 7.
Allen Parish Service District filed a motion for summary judgment
on Davis’s employment retaliation claims, which the district
court granted after determining that no constitutional violation
occurred. Davis now appeals the district court’s grant of
summary judgment. We AFFIRM.
I. FACTUAL BACKGROUND
Plaintiff-appellant Judith Brown Davis is a registered nurse
who began her employment with defendant-appellant Allen Parish
Service District (“Allen Parish Hospital” or “Hospital”) in
November 1998. She was terminated on May 5, 2003, for events
involving a mentally unstable patient on the evening of May 1,
2003.
Davis was employed in the acute care/psychiatric unit of
Allen Parish Hospital. The Allen Parish Hospital psychiatric
unit treats patients with mental instability and substance abuse
issues. Davis’s responsibilities in the psychiatric unit
included giving medications, monitoring patients, and admitting
and discharging patients.
On Thursday, May 1, 2003, Davis reported to the Hospital at
approximately 7:00 p.m. to begin working a night shift. Davis
was the charge nurse for the shift, meaning that she was the
highest ranking hospital employee in the unit and had limited
supervisory authority over the other nurses and medical

-- 2 of 22 --

3
technicians working that evening. She replaced Assistant
Director of Nursing Laurie Manuel, who was completing the day
shift. As Davis and Manuel transferred duties, they discussed
the behavior of a patient who was making intermittent threats
toward the United States President and government facilities and
property. These threats included remarks that the patient and
his friends intended to harm the President and destroy government
property and structures. The patient was of Middle Eastern
descent and often spoke in a foreign language. The patient was
confined to the ward but had access to a telephone. Davis had
previously observed the patient speaking on the phone in a Middle
Eastern language. She believed that his calls were to locations
out of the country. Davis alleges that she and Manuel agreed
that if the patient continued to make threats, the United States
Secret Service would be contacted on the following Monday.
At approximately 8:00 p.m. that evening, the patient began
making more intense threats. He began “cursing and hollering” in
English and Arabic, making threats to the President, the
government, and hospital staff. The patient threatened that he
and some people he knew were going to blow up oil fields near
Houston, Texas, that he and his friend would use their planes to
go to Washington to kill the President, that September 11 was
nothing compared to what was coming, and that he would call his
friends and have the President killed. As a result of this
behavior, Davis and the ward assistants placed the patient in

-- 3 of 22 --

1 Davis indicates that she had interacted with the Secret
Service approximately two years earlier while employed at the
Hospital. According to Davis, an individual called the Hospital
and made threats toward the President and the government. A
psychiatrist at the Hospital suggested that Davis call the Secret
Service. She did so, and Secret Service agents came to the
Hospital to speak to her. The agents instructed Davis that she
was correct to call the Secret Service, that they would
investigate and assess the credibility of any threats, and that
she should report any future threats to them.
4
four-point restraints, isolated him, and applied sedating
medication.
After restraining the patient, Davis called Manuel and
Barbara Morgan, Assistant Hospital Director, at their homes.
Davis alleges that each told her that she should do what she
thought needed to be done regarding reporting the patient’s
behavior to the proper authorities. Davis then called the Secret
Service to report the patient’s threats against the President.1
Her conversation lasted approximately fifteen to twenty minutes,
during which she reported the patient’s threats and answered an
agent’s questions about the patient’s behavior. She ended the
remainder of her shift without further incident with the patient
and left the hospital at 7:00 a.m. Friday morning, May 2, 2003.
Later on Friday, Colleen Unkel, the Director of Clinical
Services, advised Scott Barrilleaux, the Administrator/Director
of the Hospital, about the events of the previous night,
including Davis’s call to the Secret Service. Barrilleaux was
speaking on the telephone to the Hospital’s attorney, Richard
MacMillan, about another matter when Unkel made her report. In

-- 4 of 22 --

5
response to Unkel’s report, MacMillan advised Barrilleaux that
Davis should be terminated for violating patient confidentiality.
Barrilleaux conducted an investigation, which included: reviewing
Davis’s personnel file, which contained disciplinary reports
concerning prior incidents with patients; speaking with other
Hospital personnel about Davis; and speaking with Ronald Craiger,
the Chairman of the Board of Commissioners for Allen Parish
Hospital. Craiger instructed Barrilleaux to follow the Hospital
attorney’s directions and terminate Davis’s employment.
On Monday, May 5, 2003, Director of Nursing Vickie Neely
called Davis and asked her to report to the hospital early that
afternoon, before her scheduled 7:00 p.m. shift. When Davis
arrived, she met with Neely and Unkel. Neely told Davis that she
was terminating her and gave her a copy of her discharge notice,
which indicated the reason for her discharge as: “Violated
patient confidentiality by calling Secret Service. Used poor
judgment.” As Davis left the Hospital, she passed Barrilleaux
and requested a meeting to discuss her termination. Davis and
Barrilleaux met the next day, and she requested that he
reconsider her termination. Barrilleaux agreed to speak with the
Hospital’s attorney and Chairman of the Board. He was advised
that the termination would not be revoked, and he then
communicated that information to Davis.
II. PROCEDURAL HISTORY

-- 5 of 22 --

2 Davis also claimed termination in violation of other
provisions of the U.S. and Louisiana Constitutions, invasion of
privacy and defamation under Louisiana state law, and termination
in violation of Louisiana Revised Statute 23:967, Louisiana’s
Whistleblower Statute. On July 21, 2005, after the defendants
filed motions for summary judgment, Davis voluntarily withdrew
the invasion-of-privacy claim against both defendants, the First
Amendment claim against Barrilleaux in his official capacity, and
the claim against Barrilleaux individually for violation of
Louisiana Revised Statute 23:967. Because Davis appeals only the
grant of summary judgment to Allen Parish Hospital on her claims
brought under the First Amendment and Louisiana Constitution,
Article 1, § 7, we limit our discussion of her claims
accordingly.
3 The claims remaining before the district court were those
against Allen Parish Hospital and Barrilleaux individually for
termination in violation of the U.S. and Louisiana Constitutions
and against Allen Parish Hospital and Barrilleaux in his official
capacity for defamation and violation of Louisiana Revised
Statute 23:967.
6
Davis filed this action under 42 U.S.C. § 1983 against Allen
Parish Hospital and Scott Barrilleaux on April 26, 2004. Davis
claimed, inter alia, that Allen Parish Hospital and Barrilleaux,
individually and in his official capacity as Director of Allen
Parish Hospital, deprived her of employment in violation of the
First Amendment of the U.S. Constitution and Article 1, § 7 of
the Louisiana Constitution.2 Specifically, Davis claimed that
her phone call to the Secret Service was speech protected under
the First Amendment, and therefore her termination as a result of
that speech violated the Constitution.
On June 28, 2005, after discovery was completed, each
defendant filed a motion for summary judgment on all claims.3
Allen Parish Hospital adopted Barrilleaux’s arguments in toto and

-- 6 of 22 --

7
made no independent arguments for summary judgment on the First
Amendment and Louisiana Constitution claims. Although
Barrilleaux is not a party to this appeal, because the Hospital
relied on his arguments, we review them briefly here.
Barrilleaux argued that he could not be held liable individually
for Davis’s termination because he was not the final decision
maker with respect to the decision made. Barrilleaux also
asserted the defense of qualified immunity, relying heavily on
the factual circumstances surrounding Davis’s phone call to the
Secret Service. He argued that no constitutional violation had
occurred because Davis was terminated for exercising poor
judgment and violating patient confidentiality, not because of
her speech. Barrilleaux additionally argued that he was entitled
to qualified immunity because his conduct in terminating Davis
was objectively reasonable.
On September 1, 2005, the district court issued an order,
notifying the parties that because the motions for summary
judgment did not address all of Davis’s claims, the court would
consider, sua sponte, summary judgment on Davis’s remaining
claims. The order directed Davis to file “all competent summary
judgment evidence relating to any and all claims” against the
defendants, and it further permitted the defendants to respond.
All three parties complied with the court’s order.
The district court granted Barrilleaux’s and Allen Parish
Hospital’s motions for summary judgment on all claims on October

-- 7 of 22 --

8
4, 2005. The court concluded that Barrilleaux could not be held
liable individually because he was not the final decision maker
in Davis’s termination decision. Noting that neither this
defense nor the defense of qualified immunity was available to
the Hospital, the court concluded that the Hospital was
independently entitled to summary judgment because no
constitutional violation had occurred. After evaluating the
content, form, and context of Davis’s statements, the court
determined that Davis’s phone call to the Secret Service did not
relate to a matter of public concern. The court also weighed
Davis’s interest in speaking against the interests of the
Hospital, indicating that the Hospital’s interests were greater:
There is no constitutional right which affords
unfettered free speech protection to a
healthcare professional who chooses to
disclose information learned from or about a
patient in the course of treatment. Bound by
the duties of doctor-patient privilege, it is
the exception and not the rule which would
allow Ms. Davis to discuss such information
with anyone outside of the hospital.
Davis now appeals only the grant of summary judgment to
Allen Parish Hospital on her First Amendment and Louisiana
Constitution, Article 1, § 7 claims.
III. STANDARD OF REVIEW
We review grants or denials of motions for summary judgment
de novo, applying the same standard as the district court.
MacLachlan v. ExxonMobil Corp., 350 F.3d 472, 478 (5th Cir.

-- 8 of 22 --

9
2003). Summary judgment is proper if there is no genuine issue
of material fact and the moving party is entitled to judgment as
a matter of law. Id.; FED. R. CIV. P. 56(c). On summary
judgment, the evidence and the inferences to be drawn therefrom
must be viewed in the light most favorable to the nonmoving
party. MacLachlan, 350 F.3d at 478.
Davis argues that the district court erred in determining
that her speech was not related to a matter of public concern and
consequently that no violation of the First Amendment occurred.
She additionally argues that summary judgment is improper because
her interest in speaking outweighs the Hospital’s interest in
efficient operation under Pickering v. Board of Education, 391
U.S. 563 (1968). We review legal questions concerning the First
Amendment de novo. Salge v. Edna Indep. Sch. Dist., 411 F.3d
178, 184 (5th Cir. 2005). In reviewing First Amendment issues,
we are required to undertake an independent examination of the
entire record. Rankin v. McPherson, 483 U.S. 378, 386 n.9
(1987). Whether an employee’s speech relates to a matter of
public concern is a question of law that is determined by the
court. Tompkins v. Vickers, 26 F.3d 603, 606 (5th Cir. 1994).
The Pickering balancing inquiry is also a question of law.
Salge, 411 F.3d at 184; see also Kinney v. Weaver, 367 F.3d 337,
363 (5th Cir. 2004) (en banc) (“It is for the court to determine
the importance of a plaintiff’s speech interest, to determine the

-- 9 of 22 --

10
importance of a governmental interest in efficient operations,
and to balance the relative weight of each.”).
IV. DISCUSSION
A. First Amendment Framework
To prevail on a First Amendment employment retaliation
claim, an employee must establish four elements: (1) she suffered
an adverse employment action; (2) her speech involved a matter of
public concern; (3) her interest in commenting on matters of
public concern outweighs the employer’s interest in promoting
efficiency; and (4) her speech motivated the employer’s adverse
employment action. Harris v. Victoria Indep. Sch. Dist., 168
F.3d 216, 220 (5th Cir. 1999). The parties do not dispute that
the first element has been established. Rather, this case turns
on the second and third elements.
The public concern and interest-balancing elements of the
employment retaliation framework recognize that government
employees do not surrender their constitutional rights to speak
on matters of public concern simply because they are employed by
the government. Connick v. Myers, 461 U.S. 138, 146 (1983).
Indeed, government employees are often in the best position to
comment on issues of public concern, which in turn fosters
informed public debate vital to our system of self-government.
See, e.g., Pickering, 391 U.S. at 571-72 (noting that teachers
are “most likely to have informed and definite opinions” on the

-- 10 of 22 --

11
question of school funding such that their ability to speak
freely is “essential” to informed decision making by the
electorate). Notwithstanding the important interest of employees
in speaking on matters of public concern, the government has
interests “as an employer in regulating the speech of its
employees.” Id. at 568. As a result of these competing
interests, after determining whether the speech at issue relates
to a matter of public concern, our constitutional inquiry must
“arrive at a balance between the interests of the [employee], as
a citizen, in commenting upon matters of public concern and the
interest of the State, as an employer, in promoting the
efficiency of the public services it performs through its
employees.” Id.
B. Public Concern
The public concern inquiry recognizes that if “employee
expression cannot be fairly considered as relating to any matter
of political, social, or other concern to the community,
government officials should enjoy wide latitude in managing their
offices.” Connick, 461 U.S. at 146. Whether an employee’s
speech relates to a matter of public concern is determined by the
“content, form, and context of a given statement, as revealed by
the whole record.” Id. at 147-48.
The speech at issue in this case is Davis’s phone call to
the Secret Service to report a mentally unstable patient’s

-- 11 of 22 --

4 Neither party argues the applicability vel non of the
Supreme Court’s recent decision in Garcetti v. Ceballos, 126
S.Ct. 1951 (2006), to our public concern analysis. Because we
resolve this case under Pickering balancing we do not consider,
under Garcetti, whether Davis spoke pursuant to her official
responsibilities as charge nurse. Id. at 1959-61.
12
threats against the President and federal property and national
resources.4 Davis urges us to conclude that her speech, in that
it relates to the public safety, is conclusively on a matter of
public concern under this court’s jurisprudence. Davis argues
that the district court erred in determining that her speech was
not related to a matter of public concern because the context
factors it considered are properly evaluated during the Pickering
balancing phase.
On the one hand, the content of Davis’s speech weighs
heavily in favor of a conclusion that it relates to the public
concern. Davis spoke about threats to kill the President, to
destroy natural resources and government property, and to inflict
damage of September 11 proportions. In McPherson v. Rankin, we
evaluated the content of an employee’s hopeful comment regarding
a future assassination attempt on the President’s life. 786 F.2d
1233 (5th Cir. 1986), aff’d, 483 U.S. 378 (1987). Despite the
inappropriate and controversial nature of the speech in Rankin,
we concluded that “the life and death of the President are
obviously matters of public concern.” Id. at 1236. Moreover,
this court has recognized that speech “that potentially affects
public safety relates to the public concern.” Kennedy v.

-- 12 of 22 --

13
Tangipahoa Parish Library Bd. of Control, 224 F.3d 359, 373 (5th
Cir. 2000) (concluding that a library employee’s letter
addressing safeguards at the library after a rape occurred there
was protected speech because the public would be interested in
public safety at the library); see also Thompson v. City of
Starkville, 901 F.2d 456, 466 (5th Cir. 1990) (concluding that a
police officer’s allegations about officer misconduct related to
the public concern in part because widespread misbehavior within
a police force could affect pubic safety); Moore v. Miss. Valley
State Univ., 871 F.2d 545, 551 (5th Cir. 1989) (contemplating
that complaints would rise to a matter of public concern if they
had been framed as warnings that an employee was a threat to co-
workers and children instead of as internal complaints that
workplace rules be enforced equally). When viewed in light of
this public safety jurisprudence, Davis has a strong argument
that her statements fall within the public concern.
The form of Davis’s speech——a brief phone call to an
external law enforcement agency——also leans in favor of a
conclusion that Davis’s speech falls within the public concern.
The form of Davis’s speech is similar to that we considered in
Price v. Brittain, 874 F.2d 252, 259 (5th Cir. 1989). In Price,
we evaluated phone calls from a social worker to the Department
of Justice and other legal enforcement agencies to report illegal
activity occurring within a state mental facility, concluding

-- 13 of 22 --

14
that the form of those reports indicated the speech related to
the public concern.
On the other hand, the context of Davis’s speech weighs
against a conclusion that it falls within the public concern.
The context inquiry analyzes the underlying philosophical,
political, and social circumstances surrounding an employee’s
speech. Moore v. City of Kilgore, 877 F.2d 364, 371 (5th Cir.
1989). As the district court noted, Davis reported the threats
of a delusional and restrained psychiatric patient. Not only had
the threats been occurring for some time while the patient was
under a doctor’s supervision and care, but the patient, who was
restrained, was in no position to act on his threats.
Furthermore, the patient’s doctor was scheduled to examine the
patient the next morning. The district court also noted that
Davis breached the Hospital’s confidentiality policy in reporting
the patient’s threats.
Davis argues that it is error to consider these
circumstances as context factors within the public concern
determination. We agree that violation of an internal
confidentiality policy when speaking “has no relevance to whether
the subject matter of the speech is on a matter of public
concern” and that confidentiality policies are properly
considered during Pickering balancing when weighing the
employer’s interest. Salge, 411 F.3d at 185. But it is proper
to consider the position of the speaker within the workplace and

-- 14 of 22 --

15
how the position relates to the speaker’s familiarity with or
access to information about the issues on which she speaks. See
id. at 188 (reviewing the speaker’s position as a secretary, her
responsibility for maintaining good communications with the
public, and her thirty-three years of experience in the position
to conclude that her speech was of greater importance because of
the speaker’s familiarity with the issues faced). Here, the fact
that Davis made her phone call at night when the patient was
restrained and unable to act on his threats, combined with her
position as a nurse rather than the patient’s treating
physician——who was undoubtedly the person with the best ability
to gauge the credibility of the patient’s threats——weighs against
a determination that her speech falls within the public concern.
These context factors indicate that the patient was not an
immediate safety risk and that Davis was not the proper person
within the hospital to assess and report the patient’s threats.
Rather than resolve the public concern question, we may
assume without deciding that Davis’s speech relates to a matter
of public concern because we conclude that Davis’s claim
ultimately fails under Pickering balancing.
C. Pickering Balancing
Davis urges that we remand her case to the district court
for Pickering balancing, asserting that it is improper for us to
consider this evidence here because arguments were not made below

-- 15 of 22 --

5 Davis has not contended, either below or here, that the
period granted for a response was insufficient.
16
and because the district court did not decide the Pickering
balancing issue. We are unpersuaded by Davis’s arguments. This
court may affirm on any ground supported by the record below.
U.S. ex rel. Doe v. Dow Chem. Co., 343 F.3d 325, 330 (5th Cir.
2003). The record reveals that Davis did raise Pickering
balancing, however briefly, in her response to the defendants’
motions for summary judgment. More importantly, engaging in
Pickering balancing is proper now because the district court
notified the parties that the summary judgment motions did not
address all of Davis’s claims and that it would consider summary
judgment on all claims sua sponte. The court ordered the parties
to file all competent summary judgment evidence, and all parties
responded.5 Accordingly, Davis had adequate notice and
opportunity to be heard regarding Pickering balancing.
Subsequently, the district court’s ruling did weigh the interests
of the parties, succinctly concluding that the Hospital’s
confidentiality policy and the doctor-patient privilege
outweighed Davis’s interest in speaking about information gained
from a patient in the course of treatment. We therefore conclude
that our resolution of this case under Pickering balancing is
proper.
Under Pickering and its progeny, our task “is to seek ‘a
balance between the interests of the [employee], as a citizen, in

-- 16 of 22 --

17
commenting upon matters of public concern and the interest of the
State, as an employer, in promoting the efficiency of the public
services it performs through its employees.’” Connick, 461 U.S.
at 142 (quoting Pickering, 391 U.S. at 568). This analysis “in
reality is a sliding scale or spectrum upon which ‘public concern
is weighed against disruption’” to the government’s efficient
operation. Vojvodich v. Lopez, 48 F.3d 879, 885 (5th Cir. 1995)
(quoting Click v. Copeland, 970 F.2d 106, 112 (5th Cir. 1992)
(internal quotations omitted)).
Because of the wide variety of situations in which the
employment retaliation issue may arise, our balancing inquiry
requires the particularized consideration of the facts of each
case. Connick, 461 U.S. at 154. We look to the non-exclusive
factors articulated by the Supreme Court in Connick for guidance
in determining the parties’ interests and the respective weights
of those interests. These factors include the degree to which
the employee’s protected activity involved a matter of public
concern and the gravity of that concern; the extent to which the
employee’s protected activities may have affected close working
relationships; the time, place, and manner of the employee’s
protected activities; and the context in which the employee’s
activities were carried out. Connick, 461 U.S. at 151-53; see
also Vojvodich, 48 F.3d at 885 (reciting and applying the Connick
considerations).

-- 17 of 22 --

18
Although we assume that Davis’s speech meets the threshold
public concern requirement, the gravity of the patient’s threats
and the context in which Davis spoke indicates that her interest
in speaking was limited. See Salge, 411 F.3d at 195 (considering
both whether the speech at issue was accurate or confidential and
the context of the speech in determining its value for
balancing). As a general proposition, the public has a strong
interest in being informed about threats to the public safety.
The public’s legitimate interest in the threats in this case,
however, is tempered by considerations of whether Davis’s
position in the workplace made her an informed and appropriate
speaker and whether those threats were reported at the
appropriate time under the circumstances. See id. at 188. Davis
spoke at a time when the patient was restrained, sedated, and
isolated and was therefore unable to effectuate any threats for
the remainder of the evening. Additionally, the patient was
under a psychiatrist’s care and had been expressing similar
threats during his hospitalization. Given these circumstances,
and the fact that the patient was delusional, the patient’s
doctor was undoubtedly in a better position than Davis to assess
the gravity of the patient’s threats and to decide whether law
enforcement authorities should be notified. Furthermore, because
the doctor was scheduled to examine the patient the following day
and because the patient was restrained overnight, Davis’s

-- 18 of 22 --

6 The Hospital’s confidentiality policy provides:
Information about a patient’s condition,
care, treatment, personal affairs, or records
is confidential and may not be discussed with
anyone except for those responsible for
patient care and treatment without the full
consent of the patient or when compelled by
legal requirements. Only under these
conditions with specific approval of the
Administrator of the Hospital can employees
discuss a patients [sic] condition.
Carelessness or thoughtlessness leading to the
release of patient information may result in
19
concerns could have been adequately addressed by the doctor. We
conclude, then, that Davis had a limited interest in speaking.
In evaluating the government employer’s interest, we focus
on the effective functioning of the employer’s operations.
Pertinent considerations include “whether the statement impairs
discipline by superiors or harmony among co-workers, has a
detrimental impact on close working relationships for which
personal loyalty or confidence are necessary, or impedes the
performance of the speaker’s duties or interferes with the
regular operation of the enterprise.” Rankin, 483 U.S. at 388.
The Supreme Court has recognized that “[i]nterference with work,
personnel relationships, or the speaker’s job performance can
detract from the public employer’s function; avoiding such
interference can be a strong state interest.” Id.
The Hospital put forward evidence that Davis’s speech
breached the Hospital’s confidentiality policy relating to the
release of patient information.6 The Hospital’s policy provides

-- 19 of 22 --

discipline up to an [sic] including discharge.
7 Davis’s deposition indicates that she reported the
patient’s threats to a Secret Service agent and answered the
questions posed by the agent. The agent asked: what the
patient’s diagnosis was, if he was on any medicines, if he had
been in the Hospital for a while, and where the patient lived.
20
that a patient’s “condition, care, treatment, personal affairs,
or records” cannot be discussed with persons beyond those
responsible for the patient’s care unless the patient consents or
the law requires disclosure. Even under those circumstances, the
policy further provides that patient information is not to be
released without the approval of the Administrator of the
Hospital, Barrilleaux. This policy was set forth in an
acknowledgment that Davis signed when she was hired.
Davis argues that she did not breach the Hospital’s policy
because she did not release confidential information when she
phoned the Secret Service and, alternatively, that any breach was
minor because she discussed the situation with Manuel and Morgan
before notifying the Secret Service. But Davis undoubtedly did
violate the language of the policy by phoning the Secret Service,
an external entity uninvolved with the patient’s treatment;
discussing a patient’s condition, care, treatment, and personal
affairs;7 and doing so without gaining approval from Barrilleaux.
Her argument that any breach of the policy was minor by virtue of
her conversations with Manuel and Morgan is without merit. The
confidentiality policy clearly indicates that approval must be

-- 20 of 22 --

21
granted by the Hospital Administrator. Neither Manuel, Assistant
Director of Nursing, nor Unkel, Assistant Hospital Director,
occupies the position of Hospital Administrator, and so Davis’s
discussions with them prior to phoning the Secret Service do not
satisfy the confidentiality policy’s requirements.
Breach of the Hospital’s internal confidentiality policy
establishes a strong governmental interest in this case in that
the breach reflects an impairment of Davis’s ability to perform
her duties and a disruption to government operations. We are
mindful that the government’s operations in these particular
circumstances involve a psychiatric unit housing mentally
unstable patients. In a facility housing individuals who are
mentally disturbed, the employer’s need to maintain order among
employees and to limit internal disruption to psychiatric care is
paramount. See, e.g., Price, 874 F.2d at 258-59. Moreover, the
Hospital has a strong interest in maintaining patient
confidentiality in order to protect the privacy of patients and
ensure their effective treatment and to satisfy the Hospital’s
legal obligations. We thus conclude that the Hospital has a
particularly weighty interest.
Balancing the Hospital’s weighty interest in maintaining
order in the psychiatric unit against Davis’s more limited
interest in speaking, we conclude, as did the district court,
that the Hospital’s interest clearly outweighs Davis’s. Under
the distinct facts of this case, the district court did not err

-- 21 of 22 --

22
in concluding that the Hospital’s act in terminating Davis did
not violate the First Amendment.
Inasmuch as we have determined that summary judgment in
favor of Allen Parish Hospital was proper on Davis’s § 1983 First
Amendment claim, it was also proper on her claim brought under
the Louisiana Constitution. State v. Franzone, 384 So.2d 409,
411 (La. 1980); see also Delcarpio v. St. Tammany Parish Sch.
Bd., 865 F.Supp. 350, 362-63 (E.D. La. 1994), rev’d on other
grounds, 64 F.3d 184 (5th Cir. 1995).
V. CONCLUSION
For the foregoing reasons, the ruling of the district court
is AFFIRMED.

-- 22 of 22 --