Ep 1. Happy F**king Birthday

Nurse Jackie season 5 episode 1, named Happy F**king Birthday, begins with Jackie returning to the hospital after her suspension, where she is greeted with hugs and happy welcome backs. However, the reconciliation is short-lived when Jackie realizes how different things are at the hospital without her. Her closest friends, Zoey and Thor, who used to be her loyal confidants, seem to have moved on and are no longer as close as they once were. Meanwhile, someone from the past re-enters Jackie's life, which adds another complication to her already stressful situation.

The episode shifts focus to Jackie's birthday, which is supposed to be filled with celebrations and well-wishes from her colleagues and family. However, things take a strange turn when Jackie's husband, Kevin, who is unaware of her alcohol and drug addiction, plans a surprise party filled with alcohol and prescription pills in an effort to show his love for her. Jackie is shocked and unnerved by the gesture and tries to hide her uneasiness from Kevin while also trying to resist the temptation to indulge in the pills herself.

As the day unfolds, Jackie finds herself struggling to keep up with the demands of her life, both at work and at home. Her addiction is beginning to take a toll on her health, both mentally and physically, and it's clear to anyone who knows her well that she is not coping well. However, Jackie is reluctant to acknowledge the severity of her addiction and continues to mask her pain with humor and sarcastic wit.

Jackie's attempts to keep her addiction a secret are not going well. One of her colleagues, Dr. Cruz, is suspicious of her behavior and is monitoring her closely, determined to expose her addiction to the hospital authorities. On top of that, Jackie is in a precarious situation with a patient who is in a critical condition and requires her immediate attention. Jackie is forced to put her problems aside and focus on the patient, which leads to a heart-wrenching scene that leaves everyone at the hospital in tears.

The episode ends with a cliffhanger that leaves viewers on edge. The incident not only causes Jackie to reflect on her life and the choices she's made but also leads to a shocking revelation about her addiction that has the potential to alter her life forever.

Overall, Nurse Jackie season 5 episode 1 is an emotional and intense episode that sheds light on the harsh reality of addiction and its consequences. The show does an excellent job of balancing humor with the seriousness of the subject matter, keeping viewers engaged from start to finish. With outstanding performances from the cast and a skillful direction, the episode sets up a promising season ahead.