This episode actually transfers the voiceover from J.D. over to the interns towards the beginning of the episode.
The episode opens up showing J.D.'s new "power" by being the one that directly reports to Cox, the new Chief of Medicine. J.D. asks Cox to hire more nurses at the beginning of the episode. He then walks around acting like a tool as the big cheese around the hallways. Turk is slowly becoming more and more frustrated with J.D. as even the new intern he takes under his wing, Derek can see. The final straw is when Cox announces that he'll be hiring more nurses, and Carla jokes that she'll be thinking about J.D. in bed that night. Turk becomes insanely jealous. In the end it takes Derek to completely tell Cox, Carla, J.D. and Turk off to put them in their places.
Denise, meanwhile, is working with Elliot and tries to convince her to do a temporal lobe biopsy to see if the patient is going to go blind. Elliot initially refuses but eventually Denise convinces her to and when she does, the test comes back negative and the girl is left with a huge scar and a lot of tears. Elliot tells her she didn't want to the biopsy for that reason and the reasons she normally doesn't listen to interns is because they're not accountable. Denise goes in and takes the blame in the end.
Sunny, Katie and Howie are messing with the Janitor's cart when he catches them. He messes with Katie and Howie in the elevator but spares Sunny because he says she can't handle it. After spending the episode obsessing about it, she confonts him and he says that was the punishment.. making her waste her day obsessing about it.