Shift
Shift 1
Updated:
Tutorial shift — 2 scripted patients (Herbs + Eye Drops), Dr. Harlow guidance, $63 fixed reward, shutters and cameras unlock at completion.
Overview
Shift 1 is the tutorial shift — every new player's first run starts here, and the experience is heavily scripted to teach the diagnose-and-treat workflow on safe cases. Per Fandom strategic info, the first 2 patients on Shift 1 always require Herbs (Stomach Ache, see /wiki/conditions/stomach-ache) and Eye Drops (Dried Eyes, see /wiki/conditions/dried-eyes). This deterministic starter pattern means you can pre-stage both items at the start of the shift and process the first 2 patients without diagnostic guesswork.
Dr. Harlow (see /wiki/npcs/dr-harlow) is the guide throughout — he delivers the opening dialogue, walks new staff through the core loop, and unlocks the shutters and CCTV camera system at shift completion. The $63 fixed cash reward is locked-in for clearing Shift 1 successfully. No anomalies or enemies activate during the scripted patient sequence; the only documented spawns are Bed Monster and Skinwalker per AH data, both encountered at low frequency during the tutorial.
This is the lowest-stakes shift in the game. Use it to internalise the visual cues for the trauma-treatment triangle, the Photo Camera intake check workflow, and the basic CCTV monitoring pattern. Subsequent shifts ramp up significantly.
Video Guide
New Unlocks This Shift
- Shutters mechanic (unlocked end of Shift 1 by Dr. Harlow's dialogue)
- CCTV camera system (security monitor wall in Check-in Room)
- Basic patient check-in workflow at admission window
- Diagnostic + treatment loop (Photo Camera intake check + cabinet treatment items)
Easier vs Harder Challenges
Pros
- ✓ Scripted patients — no anomaly detection required on the first 2
- ✓ Fixed conditions (Stomach Ache + Dried Eyes) — pre-stage Herbs + Eye Drops for guaranteed clean clears
- ✓ Dr. Harlow guides the workflow with explicit dialogue prompts
- ✓ No emergency events during the scripted sequence
- ✓ $63 cash reward is guaranteed on successful completion
Cons
- ✗ First-time learning curve for the diagnose-and-treat loop
- ✗ Coffee Machine timing — pick up cups proactively to start the 180-second brew cycle
- ✗ Inventory pre-staging requires knowing the Shift 1 starter pattern (Herbs + Eye Drops) before it fires
At a Glance
At a Glance
- Shift #
- Shift 1
- Cash reward
- $63 (fixed)
- Difficulty
- Easy (Tutorial)
How to Survive This Shift
Approach Shift 1 as the tutorial-with-stakes that it is. Pre-stage Herbs (see /wiki/items/herbs) and Eye Drops (see /wiki/items/eye-drops) at the start of the shift — per Fandom, the first 2 patients deterministically require these items. Process them in order without diagnostic guesswork.
With the first 2 patients cleared, focus on the diagnostic discipline that will carry into Shift 2+. Run the Photo Camera intake check (see /wiki/items/photo-camera) on every subsequent patient — the 10-sanity cost per view is the tax for catching photo-class anomalies that start appearing in later shifts. Open the CCTV feed on the Check-in Room monitor wall periodically to internalise the camera-rotation rhythm.
Coffee Machine management: the Reception Coffee Machine takes 180 seconds to brew a cup (see /wiki/items/coffee). Start brewing proactively so cups are ready when you need them mid-shift. Don't waste Coffee on routine sanity recovery during Shift 1 — your sanity won't drop significantly given the scripted nature of the patient pool.
Dr. Harlow's dialogue at shift completion unlocks the shutters mechanic and CCTV camera system. These persist into Shift 2 and become the foundation for all anomaly-detection workflow going forward.
What NOT to do on Shift 1: don't try to combat-engage the Bed Monster or Skinwalker if they spawn. Maple Syrup (see /wiki/items/maple-syrup) is the Bed Monster counter — apply it if the red hitbox appears under a patient bed. Skinwalker disguise should be caught at the intake window via Photo Camera; if you accidentally admit one, follow /wiki/enemies/skinwalker for the combat workflow.
Clearing Shift 1: complete the scripted patient sequence + any additional patients in the queue + survive without hitting the 3-strike threshold. Successful completion unlocks Shift 2 and the $63 cash reward goes to your Animal Coin balance for between-shift Supplies Shop purchases starting Shift 3.
Patch History
Shift 1 mechanics have been stable since the 2026-05-10 launch. The deterministic first-2-patients pattern (Herbs + Eye Drops) is consistent in Fandom documentation through 2026-06-28. The $63 cash reward + shutters/cameras unlock pattern at shift completion has not changed across documented updates.
Frequently Asked Questions
- Always Stomach Ache (treated with Herbs) and Dried Eyes (treated with Eye Drops) per Fandom. The deterministic starter pattern lets you pre-stage both items at shift start for guaranteed clean clears.
- $63 fixed reward on successful completion. The amount doesn't scale with patient throughput on Shift 1 — it's a tutorial-shift baseline.
- Bed Monster and Skinwalker can spawn per AH data, but at lower frequency than later shifts. The scripted patient sequence (first 2 patients) does not include anomalies.
- Shutters mechanic + CCTV camera system, both via Dr. Harlow's between-shift dialogue. Both persist into all subsequent shifts.
- Yes — hitting the 3-strike threshold transitions to the Fired ending (see /wiki/endings/fired-dismissal). Even on Shift 1, wrong-treatment costs 1 of 3 lives. The scripted nature reduces the failure risk but doesn't eliminate it.
- The Supplies Shop unlocks at Shift 3, not Shift 1. The $63 cash from Shift 1 carries over toward Shift 3+ shopping. See /wiki/shop-upgrades for the upgrade options that become available.
- Per Fandom, the standard Coffee Machine brew time is 180 seconds per cup. Start brewing proactively rather than waiting until you need it. See /wiki/items/coffee for full Coffee mechanics.
- Yes — Shift 1 is the tutorial with scripted patients and a fixed $63 reward. Shift 2 onwards has random patient pools, full anomaly + enemy spawns, and variable cash rewards scaling with throughput.