Nevins explained that he wants the show to start forcing Jackie (Edie Falco) to face up to her actions.
"Next season of Jackie is going to be all about consequences," he told HitFix.
"I've been really pushing them to shake up their formula and show consequences. And by having consequences, changing some of the nature of the show."
Nevins added that he believes the fourth season of Nurse Jackie will decide the future of the series.
"Jackie is a fantastic character, with real richness and depth, but this is going to be an important crux year for the show," he said. "It's its fourth season. It needs to set itself up for more years.
"It's either going to change and adapt, and you'll go, 'Oh, there's life left in this show, in these characters', or you're going to feel like, 'That was a really good four-season show'."
Nevins continued: "I think there are things that can be done in that show, and you're going to see them. I know what they're doing. And Jackie's going to be dealing with the consequences. It's not going to be right back into the hole of her getting away with her bulls**t."
Bobby Cannavale recently signed up for a role in Nurse Jackie. Showtime has claimed that his character will "shake things up".
Production on the fourth season of Nurse Jackie is due to begin in September, and the show will return next year. The third season is currently airing in the UK on Tuesdays at 10pm on Sky Atlantic.
Watch a clip of Edie Falco in the third season of Nurse Jackie below: