"Nurse Jackie" Emmy Race Comedy Series

WARNING: SPOILERS FOR “NURSE JACKIE” SEASON SIX FINALE BELOW

The dedicated nurse and hardcore drug addict has hit rock bottom (we can only hope it doesn’t get worse) in tonight’s sixth season finale of “Showtime’s” touted series, for which Edie Falco won the 2010 Emmy for best actress in a comedy.  With the exception of maybe “Shameless” (another Showtime commodity), no show nails down addiction better than “Nurse Jackie,” where the ugliness, narcissism and selfishness of the disease is on open — and unapologetic — display.

To review: Jackie’s “secret” at-home do-it-yourself detox and subsequent sobriety lasted all of a minute, she tricked her AA sponsor into falling off the wagon and checked her into rehab, and got kicked out of ex-husband Kevin’s wedding for bringing her drug dealer as a date.  Now she’s back at work, where she nearly killed a diabetic patient by administering the wrong dosage of insulin, a mistake she’s never made, even in her most drugged-out state. Zoey, Jackie’s plucky and loyal mentee (supporting actress Emmy winner Merrit Wever), is there to witness the potentially career-ending blunder.

Zoey reluctantly confides in nursing manager Gloria Akilitus (Anna Deavere Smith), but only that it’s “somewhat possible that that Jackie [is] using drugs again.  Speculatively.” Neither one is able to face the truth in that loaded moment, the first in which Zoey is burdened with the decision of whether or not to snitch on Jackie, to whom she has always given the benefit of the doubt.

Having alienated everybody else, and sensing on a gut level that her luck is about to run out, Jackie goes to see Eddie, pharmacist-slash-enabler-slash-soulmate, at his apartment. Together, they watch footage of a catastrophic hurricane destroying southern Florida (a nod to Katrina and a running theme throughout this season). “Why does this have to happen?” asks Jackie, her eyes popped wide with grief and regret. “You can’t escape nature,” shrugs Eddie, a double entendre if ever there was one. An addict is an addict is an addict. The debilitating disease is knocking Jackie down. “But why stay?” she asks. Says Eddie, “They think they can ride out the storm.”

A foretelling of the maelstrom about to plow through her life.

They kiss.

Back in Akilitus’ office, Zoey musters the courage to reveal that Jackie nearly killed a patient. “We all make mistakes,” reasons Akilitus (whose choice to prescribe Jackie Vicodin for a foot injury that Jackie herself orchestrated is one of her more obtuse moves)

We do,” Zoey reponds. “Jackie doesn’t.”

But Zoey can’t bring herself to expose what she knows is the whole dirty truth: that Jackie was the one who stole Dr. Carrie Roman’s DEA number to score opioids at a local pharmacy, a federal offense, and that she convinced Helen, a homeless dying nun in the ER, to take the fall.

“I only want us to help her, that’s it,” manages an uncharacteristically soft-spoken Zoey. “I think Jackie needs rehab. I’m worried for her. I’m also worried for us.”

Back in the ER, Carrie (played with spot-on ditziness by Betty Gilpin) enlists Jackie’s help with an ocular trauma — a boy’s chemistry experiment has exploded in his face. She asks Jackie to start saline irrigation therapy. “He sure loves his chemicals,” says the boy’s mom, to which Jackie responds with a lopsided grin.

Nurse Thor steps in when Akilitus pulls Jackie into her office. “Have you been treating patients while impaired?” she asks. Jackie, fed up with the accusations, attempts to pin the blame on Carrie who per Jackie, is “pretending she’s a doctor.” But Jackie’s excuses are getting flimsier with each popped pill, and Akilitus is done making excuses for her. Jackie has a choice: she can enter a diversion program, which includes rehab, probation and a pay cut upon her return to work. Or she can undergo a drug test, in an hour. If she tests positive — which she inevitably will — she will lose her nursing license. For good. In the meantime, she’s ordered not to touch any patients.

In a huff, Jackie marches into ER chief Coop’s (Pete Facinelli) office, urging him to  “deal” with Dr. Roman’s “mistake.”

Zoey, feeling pangs of guilt and beside herself with worry, heads to the police station to seek guidance from Frank, whom she assumes is still dating Jackie. (To be fair, Frank’s a nice guy and all, but he was never the right match for Jackie).

“She likes her secrets,” he says, which is the understatement of this year’s cable TV season.

Back in Coop’s office, Carrie tells him that she is pregnant with his baby, huge news considering he was rejected from a sperm bank for having “slow swimmers.” They’re both elated, and Jackie’s accusation falls by the wayside.

In the hospital dispensary, Jackie has a heart-to-heart with Eddie. “If I’m not a nurse, I’m no one,” she woefully tells him. But, in her mind, diversion is just not an option: “And all the shame that goes with it? And the pay cut?” Her only solution, she believes, is to “go back in time.” She asks Eddie for help.

Jackie confronts Zoey, but Zoey lays down the law. Literally. “You used a picture of a dying nun to make a fake I.D. and then you convinced her to lie for you.” If Jackie doesn’t enter rehab, Zoey threatens to hand over the fake I.D. to the authorities.

Back at the nurse’s station, Akilitus summons Jackie. So Jackie does what Jackie does best. Sinking deeper and deeper into an ocean of denial, and with a look of piercing pain on her face, she ignores a mom’s pleading cry — “Nurse, my son needs you!” — and flees All Saints Hospital.

After cabbing it to Kevin’s apartment, Jackie begs willful teenage daughter Grace (and younger daughter Fiona) to spend the day with her and get “mani-pedis,” but Grace wants nothing to do with her. “You need help mom,” says Grace. Mia, Kevin’s new bride, accuses Jackie’s drug dealer date of stealing a bag of wedding cash. “Save your questions for our lawyer,” she tells Jackie. “Because that’s why you’re going to be talking to from now on.”

Fiona looks sadly out the window and Jackie is in tears.

At home she snorts what appears to be blow (or granular Oxycodone, her drug of choice) and packs a suitcase. Eddie meets her with a car outside, and stuffs her suitcase with dozens of bottles of pills. We’re not sure where she’s going but her flight, Eddie tells her, leaves at 5:45 from JFK. He asks to come with her, but Jackie tells him no. “You’ll be the one person I don’t hurt,” she says. “Too late,” says Eddie. So he asks her do him one favor: “Don’t die.” And she drives off.

Zoey approaches Eddie for help. “You need to do something,” she urges him. But when she discovers Jackie’s dog in the back room of the dispensary, she knows the jig is up. “Where did Jackie go?” she asks. Eddie shrugs, “Where she had to.” She cries, they embrace, and Zoey, crestfallen, asks Akilitus for a letter of recommendation for her nurse practitioner application. Rosa, a peppy new temp nurse arrives, and the timing could not be worse. In a scene that harkens back to Zoey’s first day on the job, she curtly instructs Rosa, “Sit there. Don’t talk too much. Watch what I do.”

Zoey is now in charge.

And Jackie is stuck in a traffic jam 4 miles from the airport. The clock is ticking. She pulls out onto the shoulder of the road and beholds a bloody accident scene. A man screams for help for his bleeding wife, and Jackie makes a decision. In altruistic fashion — because despite her addiction, Jackie is a savior at the core — she gets out and saves the woman, buckling a belt tight around her severed arm. “Help is coming,” she tells the husband.

Blood splattered all over her shirt, Jackie unzips her suitcase and grabs a clean sweater. A plane flies overhead. She hops back in the car and makes a sharp turn toward JFK and crashes head-on into an ambulance. Pills go flying, a slow-motion rainbow of multi-colored capsules.  A policeman shines a flashlight on Jackie, and her eyes slowly open. “Are you in any way impaired?” he asks. “No,” she groggily mumbles.

Mugshot. Credits roll. Can things possibly get any worse for Nurse Jackie Peyton?

Per Clyde Phillips, executive producer and “Nurse Jackie” showrunner, the answer might surprise you.

“Our collective sense is that she may not have completely bottomed out just yet,” he reveals, “but she’s damn close…You have to hit the absolute nadir of your life before you can start climbing toward the light, toward health, toward reclaiming your self.  That’s what lies ahead in season seven.”

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