In 1999 Arkansas, we meet Mandy, an overworked nurse battling a severe drug addiction. Her desperate measures to finance her habit extend beyond stealing patient medications—she is involved in a sinister scheme of harvesting patient organs for profit. Partnered with desk nurse Karen and recently enlisting her cousin Regina for added help, Mandy delivers harvested organs to trafficker Nicholas.
The chaotic night begins when Mandy hands over a harvested kidney inside a cooler to Regina at the hospital's rear. However, in a moment of confusion, Regina mistakenly takes a cooler filled with soda instead. The wrathful Nicholas demands to have the kidney, or else he will claim Regina's. In a frantic search for the organ at the hospital, Regina turns to a shocking choice. When Mandy refuses to assist her, Regina, disguising herself as a nurse, commits murder by poisoning a patient with bleach in a desperate attempt to procure a kidney. To her dismay, Mandy explains that the victim was on dialysis, leaving him with unusable kidneys.
The arrival of the police complicates matters as they start to investigate the murder. In a spiral of violence, Regina escalates her actions, threatening to reveal the organ trafficking operation unless Mandy helps her. Reluctantly, Mandy agrees, instructing Regina to remain outside. As panic sets in, Regina encounters one of Nicholas's henchmen and, in a misguided attempt, kills a random skateboarder, hoping to procure his kidney but mistakenly removes his bladder instead.
Inside the hospital, Mandy takes matters into her own hands, overdosing a patient to harvest his kidney surreptitiously. She leaves the organ in a cooler near a vending machine, only to discover it has vanished by the time Regina arrives.
Meanwhile, Nicholas's intimidating henchman Mikey stirs chaos within the hospital, posing a threat to Regina. In a bold move, Regina proposes to kidnap a comatose patient to satisfy Nicholas, unaware that this patient is actually Mandy's abusive half-brother, who is also struggling with addiction. Mandy intervenes, and the two join forces to subdue Mikey. The police erroneously conclude that Mikey is the perpetrator behind the hospital murders.
As Regina exits the tumultuous scene, hospital guest Mr. Kent reveals he’s been stumbling upon coolers filled with kidneys throughout the night. Exhausted, Mandy opts to take a nap in her truck. The film culminates with her returning to the hospital to begin yet another grueling shift, not long before Nicholas reappears, hinting at the unending cycle of horror and addiction that defines their lives.
