Has she done it today?
I can see that you're worried about being assertive in case it affects her wellbeing, but you have given her huge amounts of warning that you will take the next step, and she is in hospital so even if it did cause her to struggle a little, she's in the best place! Also, in terms of her long term recovery, this will be an important lesson in taking responsibility and learning that there are consequences for very badly letting a close friend down will probably help with her relationships and functioning in future!
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