I say the following as someone who has watched and enjoyed Nurse Jackie since the title character's very first pill popping: few shows on television were more in need of a change following the season three finale.

Yes, Edie Falco's performance has remained mesmerizing throughout, but nothing ever really happened. Most importantly, Jackie never really suffered any consequences. She took drugs, she lied about it; she had an affair, she got away with it.

For three seasons, this was a drama (yes, a drama. Why it's classified as a comedy in the eyes of all awards ceremonies, simply because it's a half hour long, is beyond me.) that took its lead all the way to the edge, but simply kept her there for episodes on end, refusing to drop her off it.

Until "Kettle Kettle Black Black."

The season four premiere shook up everyone's worlds, not just Jackie's, instantly re-energizing a show that had grown rather stagnant.

It appears as if a couple months have passed since Kevin's affair admission, as he's settled in to his own apartment and he and Jackie have even reached amicable terms. Eddie has waited a bit before declaring his desire to date again, and Jackie's hair has grown. So has her addiction.

Freebasing with some dude she picked up at church? Damn. It doesn't get much lower than that.

Fortunately, it didn't take long for this guy to overdose (RIP, Greenday's Billie Joe Armstrong) and for Jackie to finally (hopefully?) hit rock bottom. She's off to rehab! Toothpaste free! And the show has a whole new direction to take us in, one which could be dangerous, no doubt, as other programs have faced similar issues:

When you have a character we only know as a depressed addict, how much can you change her without altering the dynamics of a clearly successful series? It has reached a fourth season, after all.

And if you do not change her, you suffer the wrath of critics (don't you hate those people?) and fans who demand progress. I understand the dilemma. But I'm anxious to see how it will be tackled here. Best of luck, Jackie. I'm rooting for you.

Elsewhere, changes abounded through All Saints. Bobby Cannavale seems like the perfect choice to portray Dr. Mike Cruz, a new boss who is seemingly straightforward and all-business, yet fair. And who isn't looking forward to seeing Akalitus back on the floor?!?

Kevin now knows about Jackie and Eddie, while O'Hara being pregnant almost seems like too many changes at once. But, hey, I'd be a hypocrite to complain. Nurse Jackie took three seasons to establish a few interesting characters and now it's taking those characters all over the place. Let's follow them and see where it leads, shall we?

For Coop, it best lead to a bathroom, a mirror and a shaving kit. That facial hair has got to go.

Matt Richenthal is the Editor in Chief of TV Fanatic. Follow him on Twitter and on Google+.