Dr. Patricia Craven filed this action against the University of Colorado Hospital Authority (“UH” or “the hospital”), asserting: (1) a federal claim under 42 U.S.C. § 1983 for retaliatory discharge in violation of the First and Fourteenth Amendments (“retaliatory discharge claim” or “ § 1983 claim”); (2) a pendent state claim for wrongful discharge in violation of public policy (“public policy claim” or “pendent state claim”); and (3) a second pendent state claim for breach of implied contract. The court granted summary judgment for UH on Dr. Craven’s public policy claim; the others were tried to a jury, which returned a verdict for UH on both claims. The district court denied Plaintiffs Motion for a New Trial or, in the Alternative, to Amend or Alter the Judgment (“Rule 59 Motion”), and she appеals only as to the § 1983 and public policy claims. For the reasons stated below, we affirm.
Background
From March 21 through November 8, 1994, Dr. Craven was employed by UH as the Manager of Safety and Risk Management. IV ApltApp. 1149. 1 In that capacity, she was responsible for “assessing, developing, implementing, and monitoring the effectiveness of safety, security, and risk management programs for University Hospital.” II ApltApp. 1. The plaintiff became involved in a number of issues during her tenure at UH. For the purpose of this appeal, her involvement with problems relating to internal air quality, the infectious waste room, and radiation safety are the most significant.
I. Internal Air Quality
Almost immediately upon assuming her position at UH, the plaintiff became concerned аbout fumes emissions from a construction project in the Barbara Davis Center, which was adjacent to the hospital. The Barbara Davis Center was part of the University of Colorado’s Health Science Center (“HSC”), a separate but affiliated entity of UH. IV Aplt.App. 605. Fumes were seeping into UH’s ventilation system, causing internal air quality (“IAQ”) problems within the hospital. The record shows that Dr. Craven’s approach to the IAQ problem was confrontational and inflexible, and that she was consistently demeaning to HSC and other project personnel. After an early meeting with project personnel, the plaintiff circulated a memorandum to all affected areas of the hospital and to several high level officials at UH and HSC, reporting her conclusion that the fumes must be halted immediately. She did not consult her then-supervisor, Dr. Ann Jones, before circulating the memorandum. A few weeks later, the plaintiff invited ten to fifteen angry hospital employees to another meeting with project personnel. The record contains overwhelming evidence that Plaintiffs conduct at that meeting was abrasive and uncooperative. E.g., id. at 200-03, 620-22, 664, 1110-12. According to one attendee, the “meeting turned into havoc” when Dr. Craven and the hospital employees began “chanting!:] Who wants to shut them down, let’s take a vote, who wants to shut them down.” Id. at 664. As a result of these and other incidents, the plaintiff was repeatedly advised to develop a more effective problem-solving approach. E.g., id. *1223 at 1109 (5/24/94 letter); id. at 1130 (5/28/94 e-mail); id. at 1105 (6/1/94 letter); 2 id. at 1004-05 (6/4/94 e-mail).
II. Infectious Waste Room
By July 1994, Dr. Craven had become aware that “[t]he refrigerated infectious waste room on the dock [was] being improperly used[,] resulting in an increased risk of blood borne pathogen exposure.” Id. at 1017. In addition to reporting to the safety committee and consulting with appropriate hospital personnel to remedy the problem, id. at 274, Dr. Craven and her staff took a number of photographs to be used in a presentation to the hospital’s management council at their monthly meeting in August. Id. at 275-76, 399. Her then-supervisor, Ruth Sens, advised against the presentation on the grounds that given the management council’s inability to solve the problem, the presentation “would have been a complete waste of time and cause nothing but stirring the group up.” Id. at 549. Although plaintiff was allowed to compile a poster display, stand with it outside the meeting, and answer various managers’ questions as they entered or left the meeting, id. at 277, 400, she was ultimately dissatisfied with the arrangement: “I wanted to present [the problem] to everyone, not just people that had the time to stop and talk.” Id. at 278.
III. Radiation Safety Officer
Finally, Dr. Craven also clashed with her supervisors regarding the hospital’s Radiation. Safety Officer (“RSO”), Dr. Tim Johnson. In addition to her concerns about Dr. Johnson’s performance, e.g., id. at 294, 550-51, 1104, the plaintiff disagreed with the placement of the RSO position in the hospital’s overall organizational structure. Id. at 398-99, 871-72. Plaintiff was advised to еxpress these concerns to Joyce Cashman — her second-line supervisor and the hospital’s then-Chief Operating Officer. Id. at 733-34. A few days later, Dr. Craven called Dr. Ed Hendrick, then-Chief of HSC’s Radiological Sciences Division, to discuss her concerns about the RSO. 3 Id. *1224 at 306-11. Dr. Craven told Dr. Hendrick that nurses had been unable to reach Dr. Johnson to respond to a radioactive iodine spill in a chemotherapy patient’s room. The plaintiff noted that another employee had responded to the incident, but expressed concern as to who should be called upon in the future.
On November 3,1994, Ms. Sens posted a note on Dr. Craven’s door, informing her that her “communications with Ed Hen-drick! ]” had caused “major problems between UH Administration and the Health Sciences Center” and requesting “copies of all notes, E-Mails, and the context of all phone messages that you have had with [Dr. Hendrick] concerning the role of the RSO.” Id. at 1114. Plaintiff responded in writing, id. at 1115, and met with Ms. Sens the following day. After initially placing Dr. Craven on leave, Ms. Sens terminated Plaintiffs employment on November 8, 1994, due to her “lack of professional behavior and insubordination.” Id. at 1102. The termination letter described Dr. Craven’s conversation with Dr. Hendrick as “extremely inappropriate” and “in direct conflict with the information you [had] received from Joyce Cashman, Vice President of Operations, telling you to address issues regarding the radiation safety officer directly to her.” Id.; see supra, note 3. Plaintiffs internal appeal was unsuccessful. Id. at 1051, 1116-19.
Procedural History
This action was originally filed in stаte court. In her complaint, Dr. Craven alleged state claims for breach of implied contract and wrongful discharge in violation of public policy, as well as a federal claim for retaliatory discharge in violation of the First and Fourteenth Amendments. 4 I ApIt.App. 1-6. After removing the case to federal court, UH moved for summary judgment as to each claim for relief. Id. at 12-13. With respect to Plaintiffs § 1983 claim, UH argued, inter alia, that the speech for which Dr. Craven was allegedly terminated did not touch on matters of public concern, id. at 39^41, and that UH’s interests in maintaining an efficient workplace — specifically, in maintaining collegial relations with HSC and its employees — outweighed Dr. Craven’s interests in engaging in the speech at issuе. Id. at 41-43, 149-51. Although the record before us does not contain the complete transcript of the hearing on that motion, it appears that UH’s only successful argument on summary judgment was its claim of immunity under the Colorado Governmental Immunity Act (“CGIA”) with respect to the state tort claim. Id. at 154-58. Thus, a jury trial was held on the implied contract and § 1983 claims.
At the close of Dr. Craven’s case and again at the close of all the evidence, UH moved for judgment as a matter of law under Rule 50(a) of the Federal Rules of Civil Procedure. IV ApltApp. 504-27, 876-79. In both motions, the hospital’s primary contention was that the speech upon which Plaintiffs § 1983 claim was premised could not legally support a retaliatory discharge claim. As in its motion for summary judgment, UH argued that Dr. Craven’s speech did not relate to matters of public concern and that UH’s interests, as an employer, in maintaining an efficient workplace outweighed her interests, as a citizen, in speaking out as she did. Id. at 504-05, 517-22, 877. The court rejected both motions, but limited its ruling as to the protected status of Plaintiffs speech to her telephone call to Dr. Hen- *1225 drick. Id. at 518, 520-21, 523-24, 878-79. Both claims were then submitted to the jury, which returned a general verdict for the defendant on each theory. Id. at 1170-71.
On appeal, Plaintiff challenges the jury’s verdict on her § 1983 claim on the basis of six alleged errors in Jury Instruction No. 22.
Discussion
I. Federal Claim: Retaliatory Discharge in Violation of First and Fourteenth Amendments
An individual public employer is liable for retaliatory dischаrge when he terminates an employee because she engaged in protected speech.
Lybrook v. Members of Farmington Mun. Schools Bd. of Educ.,
We begin our analysis with the plaintiffs most fundamental objection: that the district court refused to instruct the jury on her theory of the case.
6
See
*1226
FDIC v. Schuchmann,
limited the scоpe of expressive activities on which [her] First Amendment retaliation claim was based just to her one telephone conversation with Dr. Hen-drick. That was not the theory of Dr. Craven’s case. She claimed retaliation based not only on that [1] one conversation, but also upon her earlier speech in connection with [2] indoor air quality problems resulting from construction activities at the Barbara Davis Center, [3] the storage and disposal of bio-hazardous waste, and [4] other matters.
Aplt. Br. at 16-17 (emphasis added). Because Dr. Craven raised this objection to the trial court before the jury retired,
see
IV Aplt.App. 818, our review is de novo.
Karnes v. SCI Colo. Funeral Serv., Inc.,
The underlying premise of Plaintiffs objection to the limited scope of Instruction 22 is that the district court erred when it ruled that the telephone call was protected, but that her speech regarding the IAQ problem, the infectious waste room, and other safety matters was not.
See
IV Aplt.App. 520, 523-24, 878-79. In order to assess the merits of the objection, we must therefore determine whether any or all of the above-referenced speech was protected.
Cf. Connick,
Of the four categories of speech upon which Plaintiff seeks to base her § 1983 claim, we must reject two at the outset. First, Dr. Craven’s allegation that she was terminated in retaliation for her speech on “other matters” is patently inadequate.
See
Fed. R.App. P. 28(a)(9)(A). It is the place of counsel, not the Court of Appeals, to identify the specific instances of speech upon which the plaintiff seeks to base her claim. “We will not mаnufacture arguments for an appellant, and a bare assertion does not preserve a claim, particularly when, as here, a host of other issues are presented for review.”
Entertainment Research Group, Inc. v. Genesis Creative Group, Inc.,
Second, the plaintiffs reliance on her speech concerning the infectious
*1227
waste room is misplaced. In any retaliatory discharge case, the threshold inquiry is whether the speech at issue involved a matter of public concern.
Connick,
Strictly for the sake of analysis, we assume without deciding that Dr. Craven’s speech regarding internal air quality and radiation safety did involve matters оf public concern, and we proceed to the second component of our inquiry: whether Dr. Craven’s interests, “as a citizen, in commenting upon matters of public concern” outweigh “the interest of the State, as an employer, in promoting the efficiency of the public services it performs through its employees.”
Pickering v. Bd. of Educ.,
Because “[t]he government’s interest in achieving its goals as effectively and efficiently as possible is elevated from a relatively subordinate interest when it acts as sovereign to a significant one when it acts as employer,”
Umbehr,
A. Internal Air Quality
Plaintiffs speech regarding the IAQ problem had a significantly adverse impact on her relationship with various HSC personnel involved in the Barbara Davis Center construction project. Because UH and HSC have, in many senses, a “common mission,” it is “extremely important” that employees of both institutions maintain “good collegial relationships” and “respect and trust each other.” IV Aplt.App. 736 (testimony of Ms. Cashman). Negative relationships between UH and HSC employees create “a lot of tension ... [and] distrust,” and have an adverse effect on the institutions’ abilities to resolve problems. Id. at 737. With respect to the IAQ problem, it was particularly important for Dr. Craven to have a comfortable and collеgial relationship with John Allison, HSC’s project manager for the Barbara Davis Center, as well as the other HSC employees and contractors involved. Dr. Craven made no attempt to foster such a relationship. In fact, it appears that she went out of her way to antagonize Mr. Allison and his team, first by copying a memorandum that concerned him directly to his supervisor and other high level officials, id. at 980, then by bringing angry staff members to a meeting at which she was rude and disrespectful to her HSC colleagues, eventually becoming so emotional that she had to withdraw from participating in the meeting in order to collect herself. Id. at 203 (testimony of Dr. Craven).
As a result, the colleagues with whom the plaintiff was supposed to be working in harmony to resоlve problems and further a common goal came to view her as “snide,” “abrasive,” “unprofessional,” “unwilling to help,” “degrading,” “nonrespectful,”
id.
at 620-22 (testimony of Mr. Allison), “completely inappropriate,” “cynical,” “argumentative,” “uncooperative,” incorporating “vigilante-ism,”
id. at
1110-12 (5/19/94 email from Mr. Allison to Mr. Pauline), and tending to create “havoc”.
Id.
at 664 (testimony of Mr. Kohler). Dr. Jones expressed her concerns about Dr. Craven’s approach to the IAQ problem on numerous occasions.
Id.
at 1108-09 (5/24/94 letter, advising the plaintiff “to slow down and think clearly,” to be more sensitive to “the appropriate manner in dealing with patients, staff and faculty,” to employ procedures that would “keep people calm rather than contribute to their anxiety,” and commenting: “I find the surprise appearance of employees at a construction meeting to be thoroughly inappropriate and need to advise you that it should not reoccur”);
id. at 1130
(5/28/94 e-mail: “[Y]our effective
*1229
ness has little to do with where you sit, but a lot to do with how you approach people.”);
see also id.
at 1105-07 (6/1/94 letter);
id.
at 1004-05 (6/4/94 e-mail). On the record before us, it was more than reasonable for UH to conclude that Plaintiffs manner, including the manner in which she expressed herself to others, was having a negative impact both on her performance and on the hospital’s operations.
See Umbehr,
B. Radiation Safety
There is no dispute as to the substance of the plaintiffs telephone conversation with Dr. Hendrick.
See
IV Aplt. App. 307-09;
cf. Waters,
Even assuming that the call did involve matters of public concern, UH’s interests in efficiency far outweigh the plaintiffs interests, as a citizen, in commenting on the radiation incident at issue to Dr. Hen-drick. From the record before us, it appears that Plaintiffs conversation with Dr. Hendrick had a “detrimental impact on close working relationships fоr which personal loyalty and confidence are necessary, ... interfere[d] with the regular operation of the enterprise,” and “impede[d] the performance of the speaker’s duties.... ”
Rankin,
With respect to the plaintiffs own performance, Ms. Sens testified that she had “explicitly advised Dr. Craven to make her concerns known to Joyce Cashman and then let it rest,” id. at 553, but that Dr. Craven “would just not give it up,” id., and that her persistence eventually went “from annoying to destructive.” Id. at 574. After Dr. Craven’s telephone call to Dr. Hendrick, Ms. Sens realized that if Dr. Craven was to continue in her position, she would require “[v]ery intense” supervision on a “[d]ay to day” basis, obligating Ms. Sens to constantly “check[ ] what she had said [and] who she had spoken to, a very inappropriate level of supervision” for a man *1230 ager. Id. at 570-71. Simply put, Ms. Sens felt that she could no longer trust the plaintiffs judgment. Id. at 571. We find the foregoing evidence sufficient to tip the Pickering balance in favor of the hospital with respect to the plaintiffs telephone call to Dr. Hendrick. 9 Accordingly, that call provides no basis for Dr. Craven’s § 1983 claim.
C. Conclusion
In sum, of the four categories of speech cited in Dr. Craven’s brief, none can provide an adequate basis for her retaliatory discharge claim. Her argument regarding speech on “other matters” is too vague, her speech concerning infectious waste did not involve a matter of public concern, and even assuming that her IAQ- and radiation safety-related speech touched on matters of public concern, UH’s interests, as an employer, clearly outweighed the plaintiffs interests, as a citizen, in commenting on those matters as she did. Accordingly, we hold that UH was entitled to judgment as a matter of law on Dr. Craven’s § 1983 claim. Because the § 1983 claim should never have been submitted to the jury, the other five errors alleged in Dr. Craven’s brief were harmless, and we need not address them. See Aplt. Br. at 16-17. We now turn to the plaintiffs pendent claim for wrongful discharge in violation of public policy.
II. Pendent State Claim: Wrongful Discharge in Violation of Public Policy
Dr. Craven’s public policy claim never reached the jury. Instead, the district court granted summary judgment for UH on sovereign immunity grounds, I Aplt. App. 154-55, rejecting Plaintiffs argument that § 24-10-106(1)(b) of the Colorado Governmental Immunity Act (“CGIA”) waived UH’s immunity as to her claim. Plaintiff renews this argument on appeal.
We review an award of summary judgmеnt de novo, applying the same standard as the district court.
Stamper v. Total Petroleum, Inc. Retirement Plan for Hourly Rated Employees,
Under § 106(1)(b) of the CGIA, “[sovereign immunity is waived by a public entity in an action for injuries resulting from: ... (b) The operation of a public hospital, correctional facility, ... or jail by such public entity....” Colo.Rev.Stat. § 24-10-106(1). The statute defines “operation” as “the act or omission of a public entity or public employee in the exercise and performance of the powers, duties, and functions vested in them by law with respect to the purposes of any public hospital, [or] jail....” Colo.Rev.Stat. § 24-10-103(3)(a). Neither the CGIA nor any other statute defines “the purpose of [a] public hospital,”
cf. Neiberger v. Hawkins,
In contrast to the dearth of case law as to the purposes of a public hospital, the Colorado courts have considered the purposes of a jail or correctional facility— also referenced in § 106(l)(b) — on more than one occasion. In both
Flores v. Colo. Dep’t of Corrections,
In
Flores,
for example, the court held that the State’s sovereign immunity had been waived where the plaintiff alleged that she had slipped and fallen “on a wet floor inside the secure visitor’s area of the [correctional] facility.”
[T]he maintenance of visitor parking areas in order to facilitate prison visitation is not directly related to the purpose, as distinct from, the operation, of a correctional facility....
Although the [Department of Corrections] has established and is maintaining a visitors’ parking lot, such function merely is ancillary to the purpose of the correctional facility. Therefore, it is not part of the operation of the correctional facility as defined under the CGIA....
Pack,
Further, we believe that the Court would agree with the court of appeals’ conclusion that “the primary purpose of a hospital is to provide medical or surgical care to sick or injured persons.”
Sereff,
Accordingly, the jury’s verdict on the plaintiffs § 1983 claim is VACATED and that claim is REMANDED to the district court for the entry of judgment as a matter of law in favor of the defendant. The district court’s award of summary judgment in favor of the defendant on plaintiffs public policy claim is AFFIRMED.
Notes
. Plaintiff's initial and supplemental appendices, both filed June 5, 2000, are cited herein as "I Aplt.App.” and "II Aplt.App.", respectively. Her second supplemental appendix, filed August 29, 2000, is cited as "III Aplt. App.” Plaintiff’s third supplemental appendix, filed June 4, 2001, and erroneously titled “Second Supplemental Appendix,” is cited as "IV Aplt.App.”
. Although the June 1 letter included a directive that Dr. Craven "[d]irect all comments about the safety of the Hospital to me as your immediate supervisor,” IV Aplt.App. 1106, the record indicates that this directive was subsequently modified or withdrawn as impracticable. See id. at 224-26 (testimony of Dr. Craven, describing meeting on or about June 29 with Ruth Sens, Dr. Jones, and Donna Koeppel, a human resources representative, about the plaintiff’s upcoming transfer to Ms. Sens' department, during which Ms. Ko-eppel had informed the plaintiff that after discussing the June 1 letter, she and both supervisors had agreed that "it would have been impossible for [Dr. Craven] to tell [Dr. Jones] even one-tenth of everything that was going on in safety,” and that the June 1 directive "was to be disregarded”); id. at 729-30 (testimony of Dr. Jones that she never intended to prevent Dr. Craven from making safety-related comments to others in the hospital, only to require that the plaintiff keep her immediate supervisor informed of those concerns).
. There is no evidence that anyone ever expressly prohibited Dr. Craven from speaking with other people
in addition to Ms. Cashman.
Thus, UH’s claim that Dr. Craven’s telephone call to Dr. Hendrick constituted an act of direct insubordination is not supported by the evidence. Nonetheless, unless Dr. Craven was discharged in retaliation for engaging in protected speech activities, "a federal court is not the appropriate forum in which to review the wisdom of a personnel decision taken by a public agency allegedly in reaction to the employee’s behavior.”
Connick
v.
Myers,
. The complaint contained allegations as to her speech regarding internal air quality and radiation safety, but not as to infectious waste. I Aplt.App. 2-3, ¶¶ 7, 9-11. Her third claim for relief did not specify the speech upon which her retaliatory discharge claim was premised. Id. at 4-5.
. A determination that speech is "unprotected” in the context of a retaliatory discharge claim does not mean that the speech "is totally beyond the protection of the First Amendment. ... We in no sense suggest that speech on private matters falls into one of the narrow and well-defined classes of expression which carries so little social value, such as obscenity, that the state can prohibit and punish such expression by all persons in its jurisdiction.”
Connick,
. In pertinent part, the challenged instruction, No. 22, read as follows:
In order for the Plaintiff ... to recover from the Defendant ... on her claim of violation of the Plaintiff's constitutional right to freedom of speech, you must find [that] ...:
(1) The Plaintiff reported to Dr. Hendrick substantial concerns she had regarding a radiation spill at 8 North of University Hospital, how that spill was handled, its adverse impact on patient care and overall hospital safety, and the unavailability of the Radiation Safety Officer to attend to such emergencies;
(2) The Defendant terminated the Plaintiff following this contact with Dr. Hen-drick;
(3) Thе Plaintiff's expression of her views to Dr. Hendrick on the issues specified in paragraph (1) above was a substantial or motivating factor in the Defendant's decision to terminate the Plaintiff;
* * * * * *
I Aplt.App. 362.
. Notably, UH has contested the protected status of the speech at issue throughout the course of this litigation. I Aplt.App. 39-43, 149-51 (Mot. for Summ. J.); IV Aplt.App. 504-05, 517-22 (first Rule 50(a) Mot.); id. at 877 (second Rule 50(a) Mot.).
. To the extent Plaintiff's argument is based on the poster display, we reject it as well. The record before us contains no evidence that anyone with the authority to terminate Dr. Craven ever saw the display.
. Due in large part to its misconception of this case as involving an alleged prior restraint, the district court reached a different conclusion as to the balance of interests with respect to the telephone call. IV Aplt.App. 523-24, 878-79. Instead of considering whether and to what extent the hospital's efficiency interests were compromised by speech in which the plaintiff had actually engaged, the court framed the question as whether the hospital's interests were directly furthered by the alleged requirements that Dr. Craven report
only
to her immediate supervisor or — with respect to radiation safety is
sues
— only to Ms. Cashman.
Id.
at 510-11, 517, 519, 523-24, 878-79;
cf. supra,
notes 2-3. It also appears that the court conflated the
Pickering
balancing inquiry with the separate and distinct analysis required to determine whether a constitutional violation by an individual government employee — if proven- — can be attributed to the governmental entity.
See, e.g.,
IV Aplt.App. 508 (statement by the court: "I’m trying to understand what custom or policy was in place by the hospital authority that prevented the plaintiff from speaking out on a matter of public concern ....");
id.
at 523 (statement by the court, concluding that the alleged reporting requirements did “in fact constitute a custom or policy that ... [was] designed in a way that doesn’t promote the efficiency of the public service being performed by the hospital authority”);
cf. Monell,
