Animal Hospital Beginner Guide: Survive Your First Shifts

Your first run in Animal Hospital (Anomaly) will probably end with an empty sanity bar and a dead patient or two. That is normal — the game teaches by punishment. This guide covers what actually matters in your first hours so the punishment stays light.

Play the tutorial, do not skip it

The first four shifts are tutorials, and they pace the danger for you. Shift 1 has two scripted patients who are never anomalies: a stomach ache (Herbs) and Dried Eyes (Eye Drops). Have both remedies ready before they reach their rooms. Shift 2 adds anomalies and unlocks the Emergency Wing and shop; shift 3 unlocks the free taser; shift 4 throws the first six-patient ambulance rush at you. The skip-tutorial option exists, but it starts you with four patients plus an immediate ambulance shift of six more — a rough opening for a first-timer. The full unlock order is in the how to play guide.

Sanity is your health bar — budget it

You start each run at 61-65% sanity, and job stress alone drains 1 point every 50 seconds. Reaching 0% kills you. Your economy:

• Coffee is free from the Reception Office machine and restores 15 total (5 per sip). Take it the instant a shift starts so the machine begins brewing the next one.
• Chocolate restores 60 total (20 per bite) but must be bought — from the shop, from Liz’s quest, or for 29 Robux.
• Mint Tea from the shop recovers 15-30 over time.

Avoid the big self-inflicted drains: tasing a normal patient (-15), looking at a cursed photo (-10 — leave polaroids on the desk), and staring at enemies like the Stalker (-10 on eye contact). The full table lives in the sanity guide.

Your first class purchase

Everyone starts with the Intern, the free default class. The cheapest upgrade in the class shop is the Nurse at 20 Animal Coins, whose level 1 perk adds one inventory slot on top of the default three (and one more per class level). Coins come steadily from play — 2 per patient treated, 0.5 per anomaly prevented, plus end-of-shift rewards — so you will afford it quickly. Compare options on the classes page before spending bigger amounts.

The mistakes that kill patients (and runs)

Holding the wrong item near a patient. The game does not check whether the item you are using is a treatment at all. Interacting with a patient while holding something they were not prescribed can kill them outright. This gets worse with the “Treat From Inventory” upgrade: with it, interacting with a patient while you have no prescribed item in your inventory kills them instantly — even if your hands are empty.

Racking up animal deaths. Dr. Harlow warns at shift 6 that three animal deaths mean you fail. Deaths also crater your shift score: one death drops you to Poor, two or three to Critical, and score determines your money. See the rating guide for the exact grading rules.

Letting anomalies through. Admitting even one anomaly caps your shift score at Good. Check appearance, behavior, the photo camera, and the security cameras before admitting anyone. When in doubt, the shutters exist for a reason — rejected normal patients just leave shocked and angry, which costs you far less than a death ritual.

Ignoring the Head Banger. If a visitor is banging its head on your window, the shutters will not close (“something is blocking the shutters…”). Dismissing it without coffee costs 20 sanity; hand it coffee instead.

A simple first-session plan

Run the tutorial, bank your early coins, buy the Nurse, and focus on clean shifts: every patient treated correctly, every anomaly rejected. That is also exactly the recipe for Excellent ratings, which pay the most money. Once you are comfortable, longer runs open up story content — and yes, the game is literally endless, so there is no finish line to rush toward.