Central Iowa nurse with a history of licensing issues faces new charges from board

A central Iowa nurse with a history of disciplinary sanctions related to alleged sexual misconduct and the misappropriation of drugs is again facing charges from state regulators.

The Iowa Board of Nursing has charged Rachel L. Blair, 35, of Ankeny with failing to comply with an order of the board, and with violating an agreement or contract with the Iowa Professional Health Program.

The board has not disclosed the alleged conduct that gave rise to the charges, except to say that it occurred while Blair was working as a nurse in Urbandale. A board hearing on the matter is scheduled for Jan. 27, 2027.

The Iowa Capital Dispatch was not able to reach Blair for comment.

State records show that in 2025, the board charged Blair with misappropriating medications or supplies from a patient or clinic.

In that case, the board alleged that on Dec. 3, 2024, the medication count was off during Blair’s shift at an unspecified care facility, with one fentanyl patch reported to be missing. During that same shift, the board alleged, Blair “fell to her hands and knees and struggled to stand.” Paramedics were called and administered Narcan, a drug that’s often used to quickly reverse a life-threatening opioid overdose.

In response to that situation, the board issued Blair a warning and she agreed to enroll in the Iowa Professional Health Program, which is designed to help healthcare providers who have substance-abuse issues. As part of her settlement agreement with the board, Blair agreed to fully comply with all requirements of the program.

State records also show that in 2020, the board charged Blair with initiating, or attempting to initiate a sexual, emotional or business relationship with a patient. The board alleged while working at the Polk County Jail from January 2019 through July 2019, Blair participated in personal, sexual phone calls with an inmate of the jail.

According to the board, Blair was fired for, on multiple occasions, providing the inmate with some unspecified form of treatment for which there was no order, and for admitting that she had personal feelings for the inmate.

In that case, the board suspended Blair’s license until she completed a six-week teleconference course on professional boundaries. Her license was then placed on probation for two years.

Court records show that a Polk County Jail inmate had told jail officials that a nurse, later identified as Blair, had been providing tobacco, drugs and sex to another inmate, who was known as “Casper.” According to a search warrant application filed by the sheriff’s department, Blair admitted to providing “Casper” with unordered, undocumented “massaging treatments,” approximately 15 times over four to six weeks, in a private treatment room.

According to the warrant application, a subsequent review of the jail’s recorded telephone calls uncovered communications between Blair and the inmate that included “sexual content and comments referencing a personal relationship.”

A review of text messages then uncovered 199 written exchanges between Blair and the inmate, according to the warrant application. The messages also included 21 photos of Blair, the sheriff’s department alleged. In addition, the warrant application alleged that money had been deposited into the inmate’s account three separate times by depositor “Clare Loren” — Loren being Blair’s middle name and the name associated with the text messages attributed to Blair.

According to the warrant application, Blair admitted destroying potential evidence in the case during the initial stages of the sheriff’s investigation of the matter.