In Ward B4 in a National Health Service Trust Hospital an unsavoury stool sample and a dead patient give the new male matron cause for concern.

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 unpleasant, she sets a chain reaction in motion that sees Hilary in tears and Kim in trouble.

The legacy of the Ivy fight has left a problem, with Kim facing disciplinary action. Kim has called in her union rep, but the meeting does little to sort out the mess. In revenge, Hilary demands the ward be shut down for a deep cleaning.

Kim, Den and Pippa struggle through another normal day on B4 ward. Kim has an unknown female to occupy her, Den has Hilary to cope with and Pippa has a ward round.

With Den and Hilary flirting behind closed doors, an incident on the ward is all it takes to trigger the blame game. Pippa has good news on her faecal forum paper and the presence of Peter Healy lightens her mood.

Kim has stepped in to cover a night shift and is looking forward to a quiet few hours, but her plan is changed by a new admission and the surprise appearance of an emotional Den.