It's July 4th at the Billy Barnes Extended Care unit of Mt. Palms Hospital in Long Beach, CA. On her first day of work, Nurse Didi Ortley discovers feces on a lounge chair, and is torn between the conflicting orders of unit veteran Nurse Dawn Forchette (who wants to file an incident report before removing it), temporary Medical Director Dr. Jenna James (who is in need of stool samples for her medical study), and Supervising Nurse Beverly Raymes (who has issues with floor cleanliness and wants the seat sterilized). In a heated argument with Beverly, Dr. James has a public meltdown, and ends up being permanently assigned to this dead-end job. Meanwhile, the staff tries to determine the identity of an Asian woman found wandering on a highway, and debate what to do with a deceased patient's birthday cake.

DiDi ends up in conflict resolution after Patsy files a grievance against her for inappropriate remarks. Dawn learns that intimacy with a co-worker is no guarantee of evaluation immunity. Dr. James and Patsy go head-to-head when she decides to skip the 'Make Someone Happy' orientation to attend a Cleveland medical convention. A patient named Birdy sends shock waves through the ward when a gentleman caller, Leonard, arrives with a romantic agenda. Patsy's announces a ward-wide deep cleaning.

Dr. James decides to implement a geriatric exercise program in the ward, upsetting Patsy, whose "Make Someone Happy" initiative now includes a live pianist and a fountain. DiDi discloses Patsy's relationship with Dawn to her union rep as proof her homophobic comment wasn't serious. A homeless woman, and her accompanying stench, is suspiciously dumped in the ward, prompting a staff investigation. Dawn wins the grand prize in Dr. James' charity raffle. Dr. James considers relocating after learning she must re-apply for a job she never wanted in the first place.