Lofty is asked to run the nursing team for a day and struggles with the pressure of his new position. He steps up and asks a disruptive patient to leave, but this soon backfires when the patient is brought back in as an emergency case. They soon manage to save her, but another silly mistake causes a agency nurse to receive a shock from a defibrillator. Big Mac tries making up with Noel, but he's having none of it. Louise tries getting to he bottom of what's going on, but he is soon popping painkillers again.

Lofty has a life-changing decision to make when he comes face to face with the consequences of his actions.