Pippa is preparing her research paper and Den and Kim deal with a male referral, but it is problem patient Ivy who dominates the day. Aggressive and deeply unpleasant, she sets a chain reaction in motion that sees Hilary in tears and Kim in trouble. Elsewhere on the ward, life and death continues as normal, but with the MRSA statistics up it seems another crisis is just around the corner. Meanwhile, Den and Hilary are starting to bond.

The legacy of the Ivy fight has left a problem, with Hilary accusing Kim of making an inappropriate remark during the fight and insisting on disciplinary action. Kim has called in her union rep to defend her, but the meeting does little to sort out the mess. In revenge, Hilary demands the ward be shut down for a deep cleaning, forcing extra work on the staff. Pippa leaves for a health conference abroad, with her stool sample research complete.

Ward B4 is a world of slips, trips and hips, where health care is at its least glamorous. Sister Den Flixter, Nurse Kim Wilde and Dr Pippa Moore assemble for ward round. The daily grind of new admissions and discharges has begun, but Hilary Loftus, the new male modern matron, has just started work and an unsavoury stool sample and a dead patient give him cause for concern. Kim finishes a slice of the dead patient's birthday cake and heads for home.