It's July 4th at the Billy Barnes Extended Care Unit of Mt. Palms Hospital. On her first day of work, nurse DiDi Ortley discovers feces on a lounge chair, and is torn between the conflicting orders of 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 a stool sample for her medical study; and supervising nurse Beverly Raymes, who has had endemic issues with floor cleanliness and wants the seat sterilized. In a heated argument with Nurse Raymes, Dr. James has a public meltdown and ends up permanently assigned to this dead-end job. Meanwhile, the staff tries to determine the identity of an Asian woman who was 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 present her stool research at a Cleveland medical convention. Birdy, a patient, sends shock waves through the ward when she and her gentleman caller, Leonard, are caught in a romantic situation. Patsy announces a ward-wide deep cleaning.