Dr. Harry Edwards is forced by the hospital's board of directors to appoint new arrival Dr. Red Buchanan as his successor for the Head of Bethlehem West's emergency department—despite Harry having promised the job to his Deputy Director, Dr. Julia McAlpine. Wayne makes a failed pass at Julia, describing to her the dreams he has had about the two of them together. Wayne and Bree are sent into the Glasshouse Mountains on a medivac to rescue an injured hiker. Tensions resurface between former colleagues Arch and Red now that the two are once again working together. Offended at being passed over for the Directorship, Julia hands in her resignation.

An accident at a theme park marks Red's first day as Bethlehem West's new Director of Emergency Services. Julia's decision to remove and injured girl from an ambulance in favour of a more seriously injured person has tragic consequences when the distraught father of the injured girl attempts to drive his daughter to the hospital himself. Oopy's decision to aggressively treat a cancer-stricken ex-wrestler upsets Gosia. After arguing with Red over the diagnosis of a patient, Wayne approaches Julia to tell her that she has his support. Red talks Julie into staying on with the promise that the department will be hers once he leaves.

A 58-year-old woman acting as a surrogate mother for her daughter-in-law and deceased son is admitted to the ER with complications. After apparently recovering, she is taken home by her insistent daughter-in-law only to be brought back in the next day, at which time she dies following an otherwise successful emergency cesarean delivery. While being transported to the hospital on a medivac flight, a patient jumps from the helicopter, landing in the river, and Arch follows the man out the door. Finding a patient collapsed in the parking lot, Macy performs an emergency tracheotomy to save the man's life. Oopy objects to Macy's actions and files a grievance to cover up his own misdiagnosis of the patient. Harry smugly announces to Red and Julia that he has become the new Chief Executive Officer of Bethlehem West

A mysterious outbreak causes panic in the emergency department. Oopy's complaint against Macy results in Harry formally charging her with ""breech of official duties"" in connection with her parking lot tracheotomy. Red's famous wife, Jane ""Colonel Doom"" Buchanan, breezes through town between international relief missions. Red approaches Wayne to tell him that his personality may not be best suited to a career in emergency medicine. On a medivac with Dr. McAlpine, Marina helps an accident victim come to terms with his circumstances when it becomes clear that his leg must be amputated in order to save his life

A terminally ill cancer patient, brought in by medivac after crash landing his glider, has his controversial last request granted and is quietly euthanised by one of the nursing staff during the night. Incensed over the ""murder"" of his patient, Wayne wants to call in the police but Harry, not wanting to draw further attention to the incident, prevents the matter from going any further. Macy is found guilty of exceeding her duties and is given a two week suspension for performing the tracheotomy in the hospital's parking lot. Arch loses the lucky drumsticks that were given to him as a child by his violin teacher.

Arch tests to become a fellow of the College of Emergency Medicine but winds up running out of his evaluation with his test patient when the man arrests in the middle of the examination. Finding her grandmother collapsed on the kitchen floor, a six-year-old girl directs the staff to her grandmother's house over the telephone. When the elderly woman dies, Macy takes the young girl home until her vacationing parents can be contacted.

While Red and Julia deal with a deadly outbreak of cholera that is ravaging a small island community, Wayne is left in charge of emergency room. Wayne seizes upon the opportunity and tries to reform the department to suit his vision, and after snooping through the personnel files, Wayne reveals to the staff that Marina is a nun. To get people to stop seeing her in a different light, Marina shows her co-workers exactly who she is. Wayne completes an order for new office chairs but the new furniture proves to be a tough fit.

Julia finds herself taking a personal interest in a severely depressed patient after he talks about killing himself and his family. Julia attempts to have the man committed to protect his wife and child, but an improperly filled out form allows him to be released back to his family. Arch, Bree, and Wayne are called out to rescue an injured sky diver but discover that they must also locate the man's detached arm. A man believed to be a Jehovah's Witness dies when the doctors cannot not give him a required blood transfusion

Dr. Edwards suffers a heart attack after refusing help from Red who had become concerned when he saw the warning signs. Bree goes on her first date with Arch but must finish it with Wayne when Arch is called back to the hospital. Gosia removes the hypnotic suggestion she implanted in Oopy as payback for his complaint against Macy. Wayne and Gosia's ambulance is rerouted to a house where a shooting has occurred. Without waiting for the police to arrive, Gosia enters the home to offer assistance and comes face-to-face with the gunman

In the face of budget cutbacks and overcrowding, Red fights to keep the ER open and off of bypass. Red's decision to accept five victims of an MVA push an already busy emergency ward into overdrive. Noticing the similarity to a situation that occurred when they last worked together, Arch reminds Red of the fatal consequences that previous decision had and warns him against allowing the same thing to happen again. Bree gets Wayne to open himself up to life when he again fills in for Arch on a date.

A needle prick received while treating a patient places Julia in a difficult position when the woman, a recovering drug addict, refuses to give her consent for a blood test. Told of Julia's predicament, Wayne illegally obtains a blood sample for testing but when the results come back, Julia, feeling compelled to inform the patient that she has syphilis, makes an anonymous phone call to the woman's GP. Wayne is subsequently arrested and charged with assault when the woman goes to the police after being discharged. While returning to the hospital with a man who has attempted suicide, Arch and Macy's medivac helicopter is forced to make an emergency landing.

A misdiagnosis by Arch leads to a tuberculosis scare in the department. Gosia lies while testifying at Wayne's hearing resulting in the assault charge against him being thrown out of court. The temporarily closure of the bathrooms in the ER causes some tense moments for Marina. Oopy's practical joke leaves him with a bad taste in his mouth.

Red's wife phones from Jakarta to tell him that she is pregnant—but that he's not the father. Wayne and Julia are forced to operate in the field when an approaching cyclone grounds their helicopter on a remote island. Before leaving for Jakarta, Red goes to Harry with his desire to have Wayne and his bad bedside manner removed from the ER. With three doctors away from the department, Harry is called upon to take over a delicate procedure from Oopy when the ambitious young intern gets in over his head. Wayne seizes upon Red's absence to endear himself to Harry.

Jane Buchanan is rushed to the hospital where an emergency caesarean delivery is performed. Marina loses track of a patient with a broken neck causing some anxious moments as the staff search the hospital in an attempt to locate him. Time constraints, coupled with mounting pressure from Julia, forces Arch to quit his band. Oopy fails his intern assessment and tells Julia exactly what he thinks of her in the process. Marina passes her evaluation but is then told by Julia that her religious beliefs may make a career in emergency medicine difficult. Red and Julia retrieve a burns victim via medivac

Marina hands in her resignation after being in a car accident that kills a patient to whom she was giving a ride home. Bree abruptly ends her relationship with Arch after introducing him to her family. Red's quiet day with his wife and newborn son (Alexander) ends in tragedy when a young boy falls off a ferry. A stranded climber requires rescuing