Elliot tasks Oliver with assisting Joseph and handing in a morbidity pneumothorax audit before the end of the day, but Oliver does not recall being told to complete and resorts to photocopying the figures from 2009.
A young boy named Sami is admitted to the hospital with idiopathic cardiomyopathy, accompanied by his mute mother and a border agent. Sami is diagnosed with biventricular failure and prepared for surgery, but Hanssen orders Elliot to stop treatment on account of potential miscommunications, prompting Sami's mother to finally speak and give her consent. Elliot and Oliver successfully insert a balloon pump to support Sami's heart, but they warn the mother that Sami will eventually need a heart transplant which would be unprecedented for a patient on the Group 2 waiting list. When briefly left alone, Sami's mother urges Oliver to allow her to leave, so Sami can be taken in by the state and moved to the Group 1 list. Oliver is conflicted, but he eventually decides to grant her request. However, a scan that Oliver has nonchalantly left on Elliot's desk shows that the balloon pump is making no difference, and Sami is given less than 48 hours to live. Elliot castigates Oliver for his negligence, prompting Oliver to admit to not finishing the audit and allowing the mother to leave. Regretting his mistakes, Oliver decides to sit with Sami in ITU who later dies.
Michael is scheduled to attend an interview for the director of surgery position at St Stephen's Hospital, but his absence from AAU quickly draws the ire of Penny whose rotation report is due later that day. Michael asks Sheena Clore to review his budget deficit strategy for the interview panel and, when he learns that Hanssen is making "distraction analysis" a core feature of Holby City Hospital's deficit strategy, asks her to discreetly access Hanssen's personal files to find out what it is with the promise that he will take her with him to St Stephen's. Sheena goes through with it, but she is caught in the act on Hanssen's webcam and suspended. Michael assures Sheena that he will do what he can to help her out, but she soon realises that he has allowed her to take all the blame and refuses Michael's offer of a position at St Stephen's. After being told by Sheena that Michael is attending an appointment about his eldest daughter's bulimia, Penny covers for Michael throughout the day and makes an insensitive comment in desperation when he fails to complete the report. However, after Michael admits that he is attending a job interview, Penny deceives him into performing surgery and warns him that his actions could potentially cost her her career. Michael decides to postpone the interview, which he later cancels, and he completes Penny's report.
Donna rallies the nurses to fight against the hospital's preferential treatment of agency nurses by refusing to train them, but her principles are challenged when attractive temp Kieran Callaghan is dispatched to Keller. Donna's colleagues begin to notice the chemistry between her and Kieran; she insists that he is not her type, but his presence on the ward is enough to distract Donna and get her in trouble with a patient. Donna apologises to Kieran for her poor treatment of him and accepts his offer of a drink, but she soon realises that he is a player when he notices her flirting with another nurse and dismisses him. Nevertheless, when Hanssen confronts Donna about her campaign and points out that allowing temps to work without training consists gross misconduct, Kieran steps up and vouches for her, but Donna later tells Kieran that she will be recommending that he not work on Keller again.
- Emma Catherwood as Penny Valentine
- Hari Dhillon as Michael Spence
- Rosie Marcel as Jac Naylor
- Jaye Jacobs as Donna Jackson
- La Charné Jolly as Elizabeth Tait
- Guy Henry as Henrik Hanssen
- James Anderson as Oliver Valentine
- Paul Bradley as Elliot Hope
- Luke Roberts as Joseph Byrne
- Bob Barrett as Sacha Levy
- Niamh McGrady as Mary-Claire Carter
- Barry Sloane as Kieran Callaghan
- Elliot Speller-Gillott as Sami
- Anamaria Marinca as Sami's mother
- Kathryn Hunt as Kathy Flannery
- Victoria Yeates as Sheena Clore
- Kenneth Colley as Vaughn Chewer
- Caroline O'Neill as Deborah McDowdy