After Nebraska firings, nurse faces Iowa charges for drug theft

A registered nurse fired by four Nebraska hospitals is facing disciplinary charges in Iowa for allegedly stealing controlled substances, highlighting potential gaps in how states track healthcare workers moving across licensing borders.

According to reporting from the Nebraska Examiner, the Iowa Board of Nursing has charged Bailie Anne Preston of Emerson with misappropriating medications and unauthorized possession of controlled substances. Preston was working at Shenandoah Medical Center in Iowa when she was criminally charged in September 2025 with theft and felony drug possession for allegedly stealing injectable morphine sulfate from the facility.

Preston's case reveals how the Nurse Licensure Compact, an interstate agreement allowing nurses to practice across state lines with a single multistate license, can continue to permit employment even after regulatory problems in one state. Nebraska officials alleged that in December 2024, a month before Preston moved to the Iowa facility, she was fired from Community Medical Center in Falls City, Nebraska, after missing Benadryl vials were discovered.

The nurse's Nebraska employment history showed a pattern of concerns. Nebraska regulators alleged Preston was fired from Nebraska Medicine in Omaha in 2023 for failing to respond to a critically ill patient, failing to complete education requirements, and repeated absences. She was then dismissed from Nebraska Methodist Health System in Omaha in September 2023 for leaving her post extended periods and inadequate patient care documentation.

Most concerning was an incident at Johnson County Hospital in Tecumseh on December 15, 2023, when Preston allegedly documented giving a patient morphine for pain but the patient reported not receiving medication. A colleague found an empty syringe in a bathroom Preston had entered. When the hospital requested a drug screen, Preston refused and was subsequently fired.

Despite these Nebraska actions, Preston retained her Iowa nursing license through the interstate compact and continued working. Nebraska officials attempted to contact her in May and June 2024 but reported she never responded. In August 2025, she began working at the Iowa facility.

At Shenandoah Medical Center, police alleged Preston took a box of morphine sulfate vials while on duty, hid the item under her clothing, placed it in her vehicle and took the medication home. The vials were not recovered, but the discarded box was found in a dumpster. Preston pleaded not guilty to criminal charges with trial scheduled for May 26, 2026.

In November 2025, Nebraska officials settled disciplinary charges against Preston, who agreed to a two-year-minimum revocation of her Nebraska nursing license and a $2,000 civil penalty. Iowa's disciplinary hearing is scheduled for June 30, 2026.