I have been a nurse researcher with a successful program of research and funding track record. For much of my career, I was most comfortable when I could develop robust study protocols and measure things. My research training is grounded in quantitative and mixed methods. And much of my work has focused on understanding health systems and the human factors that influence quality and safety of healthcare, with special emphasis on medication safety. I have used large datasets, advanced statistical methods, and, more recently, machine-learning approaches to identify patterns, test relationships, and better understand why errors occur. I enjoyed the structure of this work: the ability to carefully design a study, define variables, develop an analytic plan, and use data to answer a research question. I conducted most of my work in various healthcare settings. 

Then I began to transition my work on medication safety to K-12 schools, an under-resourced community setting. Initially, I questioned my decision to leave my comfort zone and move to implementation science to apply technology in a totally new environment. I thought stepping into schools with a solution to one of their care-delivery challenges with leadership support and change champions behind me would make my life easy. But that was far from the truth.

My work designing and implementing an electronic school medication administration record (eSMAR) brought me into a situation that was very different from the controlled research processes I knew well. With my team, I was introducing technology into busy K-12 schools, where nurses, office staff, administrators, information technology teams, parents, and researchers all viewed the system through different lenses. A solution that seemed straightforward from a research or technical perspective didn’t necessarily fit the realities of school settings. Workflows changed. Technology behaved differently across settings. People used the system in ways we had not anticipated. Priorities shifted. And I could not control all or any of it. 

As a quantitative researcher, I had been trained to think carefully about controlling sources of variation. In implementation work, I began to realize that some of that variation was not noise to be controlled; it was information I needed to understand. Context mattered, workflow mattered, relationships mattered, perspectives of the people who will use an intervention (the thing we developed) mattered—all of these perspectives are as important as the intervention itself. That realization became my introduction to implementation science. 

I began learning new ways of asking questions. Instead of only asking, “Does this intervention work?” I became increasingly interested in questions such as: “What will it take for this intervention to work here? What makes people willing or unwilling to use it? How does an intervention need to change to fit a particular setting without losing what makes it effective? And how do we build something that can continue after the research project ends?”

This has been a challenging and energizing shift for me. I am still someone who loves data, measurement, and rigorous analysis. I have not left that part of my scientific identity behind. Instead, implementation science has expanded it. It has taught me to become more comfortable with complexity, to listen before trying to solve, and to recognize that successful implementation often requires adaptation, iteration, and shared decision-making rather than control.

Now my passion is implementation science and implementing “things” in real-world settings. Now I embrace the “gray zone” of uncertainty and lack of total control. There is a certain discomfort in moving from an area where you feel highly competent into one where you do not always have the answer. In implementing my eSMAR, I faced, and am still facing, countless setbacks and challenges. I have come to value that discomfort. It keeps me curious and reminds me that implementation science is inherently collaborative. No single discipline, method, or researcher can fully understand a complex implementation problem.

As a Nurse Lead within the University of Iowa Implementation Science Center, I bring to my work a strong quantitative and mixed-methods perspective, expertise in health systems and medication safety, and firsthand experience learning what happens when an evidence-based idea meets the complexity of the real world. I also bring the perspective of someone who is still learning, and who genuinely enjoys that process.