Wipe the skillet dry, turn the heat to medium-high, then add olive oil to the skillet. Once the oil is hot, add the sausage (if using) and cook until browned breaking it up with a spatula, for about 5 minutes. Remove with a slotted spoon, and discard all but 1 tablespoon of drippings. Stir the onion and garlic into the skillet. Cook over medium- low heat until the onion is tender, about 5 minutes. Add the mushrooms, increase the heat to medium-high, and cook, stirring, until the mushrooms have softened and exuded liquid, and that liquid has cooked off, about 5 minutes. Stir in the cream, salt, pepper, nutmeg (if using), chopped spinach, and reserved sausage (if using) and bring to a simmer. Remove the skillet from heat and let cool slightly.