A hospital and health system in California is facing a lawsuit from a nurse who says she was fired for blowing the whistle on unsafe working conditions that threatened patients and staff.

Teresa Brooke, former chief nursing officer (CNO) at Aurora Santa Rosa Hospital, an acute psychiatric facility in Sonoma County operated by Aurora Behavioral Healthcare and Signature Healthcare Services, says she only wanted a safe environment for her staff and patients. Her lawsuit alleges the health system was more concerned about profits than dangerous conditions at the hospital.

Severe staff shortages resulted in injuries to patients and staff during her time as CNO, she claims. The facility provides inpatient, partial hospitalization, and outpatient mental health services to adults and adolescents.

Brooke had 30 years’ experience in nursing and hospital management before joining the Aurora facility, according to her attorney Xinying Valerian, JD, of Valerian Law in San Francisco. Brooke raised her concerns both internally and to a government agency, and was summarily fired, Valerian says.

She is seeking general economic and noneconomic damages, special damages, punitive damages, permanent injunctive relief, legal fees, pre- and post-judgment interest, and other relief the court may find appropriate. The health system did not respond to a request for comment.

Her whistleblower lawsuit alleges wrongful termination and retaliation in violation of several provisions of the California Labor and Health and Safety Codes.

The complaint details numerous examples of dangerous conditions at the hospital, including severe staff shortages that resulted in injuries to patients and staff. Brooke claims that Aurora and Signature illegally fired her for complaining about those conditions.

The case illustrates the elevated risk that comes from mishandling the sometimes inevitable clash of business and clinical priorities, Valerian says.

“Teresa Brooke is an experienced nurse and manager, but what she saw at this facility was worse than anything she had seen before, and she was rightly concerned,” Valerian says. “There is inherent risk in overriding the judgment of your top clinical leaders and allowing business decisions to interfere with clinical and safety decisions. It is appropriate to set business goals for your facility, of course, but problems come when the business side gets involved at the granular level day to day.”

The complaint alleges that staff and patients “were subjected to routine punching, kicking, choking, and, on one occasion, even a full-blown patient riot” and that the staffing shortages “led to high incidence of patient self-harm and multiple occurrences of sexual violence involving patients, some of them minors.”

Aurora and Signature prioritized profits over the care and rights of patients and hospital staff, the lawsuit claims. Brooke tried to limit admissions and increase staffing, but met resistance from corporate leaders, she says. Instead of respecting her admissions caps and limits on after-hours admissions when on-duty staffing was inadequate, the health system decided to open an additional patient unit.

“When you’re talking about staffing concerns, you can’t separate concerns [about] the safety of workers and the safety of patients. They’re all intertwined,” Valerian says. “Inadequate staffing put them all in harm’s way.”

Brooke filed a complaint about understaffing and unsafe conditions with the California Department of Public Health (CDPH) in fall 2016 and says she was fired without warning soon after.

CDPH investigated Brooke’s complaints and “substantiated and validated” them, according to the lawsuit.

The complaint alleges numerous California Labor Code and OSHA violations, including chronic understaffing, unsafe placement of patient seclusion and restraint rooms, unsafe administration of medications, failure to provide sufficient hand-washing and sanitizing stations, lack of a workplace injury and illness prevention program for employees, failure to provide staff with suitable seating, and illegal confidentiality policies and practices for employees.

The complaint cites nine causes of action, including wrongful termination, retaliation in violation of several provisions of the California Labor and Health and Safety Codes, solicitation of an employee by misrepresentation in violation of the California Labor Code, and a private attorney general enforcement claim.

“My client was fired only a few weeks after she went to the state public health department, and there was no replacement lined up to fill this critical leadership role. So, from a lawyer’s perspective, the closeness in time between a protected activity such as filing a complaint with the authorities and the adverse employment action was a critical factor in determining the strength of this case,” Valerian says. “She had no warning, a positive performance review a couple of weeks prior, so there was nothing to substantiate the termination.”