New operations manager Jan Jenning arrives in Holby and is not impressed by Iain and Sam's rather playful work ethic. They are later called to an incident in a storm drain where a boy's leg has become trapped. With the water rising, they consider amputating his foot, but he refuses to give his consent. However, believing that he will die otherwise, Sam decides to amputate regardless.
Back at the emergency department, Sam feels guilty about her actions. She and Iain are confronted by the boy's heroin-addicted sister, who threatens to expose that they didn't have his consent to amputate if they refuse to give her money. They inform Jan, who promptly deals with the situations, albeit in an unorthodox manner. Later, at the ambulance station, Jacob gives Sam an old punching bag as a present.
Following Bea's resignation, Connie tasks Ethan with finding a replacement for her. Meanwhile, Louise takes a man named Dougie into the ED after finding him outside with a broken arm. He calls his daughter, who happens to be Bea, and asks her to pick him up. She reluctantly returns to the hospital and is immediately noticed by Connie, who reprimands her for running away from her mistakes.
In resus, Bea tells the team that Dougie is taking disulfiram to help him abstain from drinking, and Dylan points out that his symptoms suggest that he has been consuming alcohol. Although Dougie insists that he hasn't fallen off the wagon, Bea refuses to listen and leaves. Later, Rash learns that Dougie's symptoms are a result of antibiotics and goes to find Bea. Regretful that she missed her own father's symptoms, she decides to confirm her resignation. However, after Dylan reminds her that making mistakes is part of the job, she chooses to remain in Holby.