In the wake of Beverly’s departure, a new (male) Supervising Nurse, Patsy De La Serda, joins the Billy Barnes staff with a customer-centric, "cruise-line based" agenda that he’s convinced will improve ward ratings. Patsy soon learns that managing patients – especially highly uncooperative and feisty ones like Varla – isn't necessarily improved through customer-service metrics. On the other hand, a more docile patient named Donna wins DiDi's affections and displays impressive karaoke skills.

DiDi deals with her younger sister, who's filling in on the ward and trying to impress Dawn. Dr. James encounters resistance to her research methods, an award goes to Patsy's head, and the staff are anxious to discharge a particular patient.

With the ward's fate up in the air, DiDi hunts for ways to save it, while dealing with pressure from Dawn to be her health advocate. Troublemaking Varla returns, and butts heads with her equally opinionated long-lost daughter. Caught in a mountain of lies, Jenna comes clean to her husband, Richard. After a memorial service full of drama, the staff gets a rude awakening.