Now in its fourth season, Nurse Jackie is still a collection of strong performances in search of a worthy show. A prime example of Showtime's high-concept, patchy-execution creative model, the series is narratively and tonally inconsistent. Half-hour format notwithstanding, it's too rife with hot-topic subplots—drug addiction, juvenile delinquency, mental illness—to be considered a comedy, while remaining too goofily lightweight to be taken seriously as a drama.
One shortcoming from previous seasons continues to persist: the absence of lasting consequences to Jackie's (Edie Falco) shocking behavior. She's lied, stolen, and snorted her way through three years of story material without so much as a professional reprimand. As before, her life continually threatens to unravel, but she's always pulled back from the brink by increasingly labored plot machinations. To their credit, show runners Liz Brixius and Linda Wallem do try to shake up the status quo more than in past seasons. Jackie goes to rehab, her husband moves out and initiates a custody battle, prominent characters get fired, Thor (Stephen Wallem) loses his braces. A potential game changer is the introduction of a new, reform-minded administrator, Mike Cruz (Bobby Cannavale), a representative of the corporation that's bought All Saints Hospital.
Unfortunately, none of these soap-operatic complications seem to have much of an effect on anyone. Earth-shattering revelations are greeted with incongruously forgiving reactions. Firings are taken in stride, with an "Oh well" and a cocktail. Developments that would generate shockwaves and be felt seasons later in your average HBO drama are forgotten or reversed in an episode or two here. Through it all, Jackie remains relatively untouched. It would hardly be a spoiler to reveal that, by the end of the season, she's still a nurse at All Saints.
What carries the series is the strength of its cast: Falco continues to turn in a note-perfect, nuanced performance as Jackie, Merritt Wever is still putting in one of the most underappreciated comic turns on TV as Zoey, Peter Facinelli is dependably funny (in a sophomoric sort of way), and Eve Best brings no-nonsense dignity to the role of Jackie's doctor friend. Paul Schulze infuses sad-sack pharmacist Eddie Walzer with Droopy Dog-ish resignation, his scenes with longtime friend and collaborator Falco never failing to reflect the two veteran actors' chemistry. Cannavale fares less successfully, mostly due to inconsistent character beats that contradict each other from episode to episode; the writers seem unsure of whether to pitch him as a corporate heavy or a figure of sympathy.
The weakest link is recurring guest star Jake Cannavale (whose last name telegraphs an obvious plot twist) as Jackie's fellow rehab patient and the latest addition to the recent glut of irritating teenagers on television. Nurse Jackie's pleasures lie in the smaller moments and interactions that are buried in a morass of contrived narrative threads. Watching the hospital staff interact with various patients is often a delight; of particular note this season is Rosie Perez as a terminally ill but unwaveringly cheerful woman who develops a mutually empathetic bond with Jackie. There are some terrific scenes built around ER chatter and the interplay between the staff. If only the overall fabric of the plot meshed together as well.