After three days hiding in Claire’s cellar, Una is awakened before dawn by a coal delivery. Examining her pockets, she finds only Barney’s bent silver pin, worth about a dollar. She needs at least $10 to leave New York, a city she loves but must abandon to avoid prison on Blackwell’s Island.

Una discovers a magazine article about the Bellevue Training School for Nurses, founded in 1873. The two-year program offers free room, board, and a modest stipend. Una devises a plan: hide in plain sight as a nurse trainee, where police will never search for her. Afterward, she can use the profession as a new con, gaining access to wealthy homes.

She meets most qualifications but must forge school transcripts and reference letters. Reluctantly, Claire gives Una a dress and money for the train. Traveling to Newspaper Row, Una panics when she spots a headline about the escaped con woman connected to the Sixth Ward murder, listing four of her aliases.

Safe at Barney’s newsroom, she asks him to create forged documents from Father Connally of Augusta, Maine, and St. Agnes’s Girls’ School. Despite his skepticism about her nursing ambitions, Barney agrees to help manufacture the papers.

Una arrives at the nursing school headquarters for her interview, wearing another borrowed dress. Miss Hatfield, a cold head nurse, greets her at the door, noting she is almost late and emphasizing punctuality.

In the library, Una is impressed by the comfortable furnishings, imagining it as a perfect hideout. Miss Hatfield makes condescending remarks about Una’s education. Two additional women join them: Mrs. Hobson, a silk-clad board member, and Superintendent Perkins, the shrewd leader who will make the final decision.

Una recites her rehearsed story, mixing truth with lies borrowed from her mother’s history, including the claim that her mother died in a fire, inspiring her to honor that memory through nursing. Mrs. Hobson is moved to tears, but Miss Perkins remains unreadable when she reveals they have nearly 1,000 applicants and warns of the program’s demands. When Mrs. Hobson asks about Una’s religion, Miss Hatfield reacts with disdain upon learning Una is Catholic.

Feeling her chances slipping, Una makes an earnest final plea. After a tense silence and glances between the women, Miss Perkins welcomes Una to the program, praising her pluck but issuing stern warnings about the exacting requirements.

Four days later, Una returns to begin her probation, carrying a valise with her few possessions. Claire gave her the bag on condition she never return; Una stole another of Randolph’s pens on her way out.

Mrs. Buchanan, the resident housekeeper, greets her and provides a tour. Una is impressed by the decor, internally noting the value of items while reminding herself not to steal from housemates. The tour includes the dining room, the kitchen overseen by Cook Prynne, and a modern water closet with a flushing toilet, which Una views with suspicion.

In the library, Una notices a framed letter from Florence Nightingale advising on nurse duties and emphasizing subservience to doctors. A cheerful young woman approaches, introducing herself as Drusilla Lewis (who Una calls Dru), and speaks enthusiastically about Nightingale and nursing. Mrs. Buchanan reveals that Una and Drusilla are roommates.

Dru leads Una upstairs to a spacious room far superior to Una’s previous flat. While Dru makes Una’s bed, Una habitually checks for hidden threats. She tests the plush mattress by leaping onto it. When Dru suggests a nap before supper, Una reluctantly removes her boots but hides them under her pillow, still not trusting her new roommate.

The next morning, Una wakes on time but falls back asleep, which forces them to rush across 26th Street. Una grows irritated by Dru’s slow pace and grabs her hand to pull her through the crowd. They arrive at Bellevue Hospital, a hulking gray fortress, just as Superintendent Perkins addresses the trainees about discipline and obedience. Una scoffs at talk of divine purpose, resolving only to keep her head down and avoid prison. Perkins introduces the six head nurses, including Miss Hatfield, who will oversee their training.

Hatfield gives a stern speech, warning that at least 10 probationers will be dismissed within a month and listing tardiness as intolerable while staring directly at Una. She asks if anyone feels unequal to the challenge, again focusing on Una, who returns her cold stare. Una realizes that she has already failed to go unnoticed.

During the hospital tour, they pass Ward 25, where doctors treat a man with a gruesome factory injury. Several probationers react with horror; one vomits, another faints and hits her head. Dru clutches Una’s arm, pale, but Una steps closer, curious about the treatment. When a dropped syringe rolls to Una’s feet, Miss Hatfield orders her to step back.

Dru whispers that Hatfield does not like Una.

Una is assigned to surgical ward six under Miss Hatfield’s supervision. Her first 12-hour shift exhausts her with menial tasks like mopping vomit and hauling soiled dressings. At supper, she begins eating before grace and is chastised for being a “papist,” to which she responds sarcastically, making a deliberate sign of the cross afterward.

The next day, Una is late for morning lecture after using a privy down the street instead of the water closet. Miss Hatfield stops mid-lecture and publicly quizzes Una on dust composition. When Una answers incorrectly, Hatfield humiliates her. Dru steps in with the correct response.

On the ward, Una completes her cleaning and bed-making tasks, but when Hatfield inspects, she questions Una’s carbolic acid ratio. They are interrupted when a second-year trainee reports a patient is hemorrhaging. Hatfield examines the bleeding surgical incision and sends Una for carbolized water with a specific ratio. Una returns with water, a sponge, and rags. Hatfield uses the rags but scolds Una for bringing a sponge, explaining it can convey poison between wounds.

Then, because Una made the beds incorrectly without draw sheets, blood soaks the mattress. Hatfield forces Una to remake all the beds properly, then orders her to take the soiled bedding to the laundry and report to Superintendent Perkins.

Una carries the soiled linen and mattress across the lawn toward the laundry, where she encounters bone-thin, vacant-eyed workhouse women from the Tombs or Blackwell’s Island, toiling endlessly. Horrified by this glimpse of her own fate if captured by police, Una resolves to succeed at Bellevue.

In Superintendent Perkins’s office, Una prepares for expulsion. Perkins states that Miss Hatfield reported Una’s difficulties. When Una tries making excuses for her tardiness and mistakes, Perkins cuts her off, stating her behavior suggests unsuitability for the program.

Una drops the excuses and genuinely pleads for another chance. After a lengthy silence, Superintendent Perkins emphasizes that nursing is a serious profession and that inefficiency and insubordination will not be tolerated. She issues a final warning: If Una is sent to the office again for any reason during her probation, she will be dismissed immediately. Una thanks her profusely and promises she will not regret the decision.

Una resolves to be a model probationer, waking early, arriving to lecture on time, and being attentive. On the ward, Miss Hatfield constantly tests Una on principles learned in lecture, scrutinizing her actions regarding ventilation, temperature, and cleanliness. After two weeks, Una learns to read patients’ needs and anticipate Hatfield’s afternoon rounds at four o’clock, preparing the ward meticulously beforehand.

One morning, Una notices a patient sweating, shaking, and speaking gibberish. Recognizing delirium tremens (even though she does not know the term itself) from experience with her father’s alcohol addiction, she gives him brandy. When Dr. Pingry, a senior physician, arrives for rounds with other doctors and Miss Hatfield, he smells brandy on the patient’s breath and becomes furious. The second-year trainee blames Una, who admits administering it and explains her diagnosis.

Dr. Pingry scolds Una for overstepping her duties and intellectual capacity. As she faces dismissal, a young doctor, Edwin Westervelt, speaks up, falsely claiming he gave the order. Dr. Pingry chastises the decision and makes a disparaging remark about Edwin’s family history. After they leave, Una wonders about Edwin’s motive for helping her.

When she later confronts him, Edwin explains her observation may have saved the patient’s life and reveals his father had an alcohol addiction. Una is disarmed by him and senses he, like her, does not quite fit in.

The next morning, trainees gather in the library for their first physician-led lecture. A table displays human bones, triggering Una’s cemetery memories. When trainees discuss grave robbing, Dru explains the 1854 Bone Bill legislation that ended the practice by providing medical schools with unclaimed bodies.

Dr. Pingry arrives to lecture on anatomy, recognizes Una, and looks displeased. He proceeds with a talk on the skeleton, and Una’s mind wanders. When Pingry asks for spine-related ailments, several trainees answer. His gaze lands on Una, challenging her. She answers “hunchback,” which he corrects as kyphosis. Una suppresses her anger, determined not to give him reason to report her.

Then, Pingry announces a surprise examination. Panicked because she did not listen to the lecture, Una tries copying from Dru’s slate but cannot get all answers before Dru turns hers in. Desperate, Una creates a commotion by tripping another trainee, who collides with the display table, scattering bones. While helping clean up, Una surreptitiously memorizes answers from another woman’s slate.

Una presents her examination to Dr. Pingry, who scrutinizes it closely but passes her. As he hands it back, she pickpockets his watch in retaliation. That evening, she hides the watch in her trunk’s lining, realizing she cannot rely on cheating. Una goes downstairs and asks to join Dru in studying.

Two days later, Una finds the second-year trainee, Nurse Cuddy, vomiting on ward six. Una suspects pregnancy; the woman denies it but asks Una to escort patient Mr. Kepler to surgery in her place, insisting Miss Hatfield must not know she is ill. Una agrees in exchange for good reports during her probation.

Following orderlies with the stretcher, Una enters a tiny room that turns out to be an elevator, thrilling her with her first ride to the fifth floor. She enters the operating theater, a large room with tiered seating already filling with male students. The frightened patient, Mr. Kepler, looks to Una for comfort; she takes his hand.

When an assisting nurse questions Una’s presence, she lies, claiming she is a nurse and has theater experience. She gathers supplies, though the nurse sends her back for additional items. Then, the surgical team arrives, led by Dr. Pingry. Una freezes, hoping he will not recognize her. Absorbed in the surgery, he ignores her completely. His interns are Dr. Allen and Dr. Edwin Westervelt. Pingry chastises the nurses when the patient is not yet positioned correctly. Edwin, the junior assistant, administers ether to Mr. Kepler.

Una watches the lithotomy procedure, cleaning sponges as needed and marveling when Pingry removes a bladder stone. Her attention drifts to Edwin, whom she finds handsome, and senses has grit beneath his polished exterior. He looks up and meets her gaze; Una flushes and quickly looks away. After surgery, Pingry gives instructions without recognizing her. Relieved, Una feels confident she will pass probation.