Written by: Patti Dollarhide

Paula Ghazarian

“Paula, do you want to go on a road trip?”

“Sure, where to?  We made great memories when we traveled to the nutrition conference in Miami on the beach a few years back.  When and where?”

“June 20, 2019 at Hy-Plains Education & Research Center, Montezuma, KS.  Be sure to wear close-toed shoes.”

And that is all it took to get my friend Paula Ghazarian, RN, leader of the Infection Control oversight team at one of the largest hospitals in Kansas for many years, to attend the “Appropriate Antimicrobial & Use & Stewardship” conference several hundred miles away.  She is a life-long learner who pursues learning no matter what the time or setting.  Paula was raised in West Virginia and has stories about raccoons, squirrels and prized coon dogs that make you laugh so hard your stomach hurts, but we soon found that cattle chat was a foreign language to her.  The cattle talk took us to other health-related topics.  I could feel some common ground as she shared her frustration with parents who choose not to vaccinate their children, resulting in outbreaks of vaccine-preventable diseases.  This easily translates to the cattle business as our customers want us to stop using antibiotics to treat food animals.

We arrived at the Hy-Plains feedlot a little early, and Tom Jones took time to give Paula a tour of the cattle processing area.  Her morning started off with amazement.  “I had no idea it would be so calm, quiet and clean.  I was expecting chaos and very bad odor.”

Paula asked a few questions that were easy to answer, as well as some that don’t really have answers.  She was disappointed that a retailer she held in high esteem due to their stand against antibiotics in chickens has created a trade-off that includes a negative effect on animal welfare.  Increasing animal mortality is not the outcome she wants.

As the day went on, speakers discussed opportunities in our business to reduce stressors that drive how we currently use medically important antibiotics   Modern beef production is a highly specialized business in which technology has allowed farmers to produce more food for a growing world and still stay in business – a cattleman’s ultimate definition of sustainability.

Two different times during the day, questions came from the agriculture audience wondering what the human medical community is doing to address appropriate use and stewardship.   We know, and they know, that there are opportunities.  Paula shared multiple examples on our return trip of how practices and procedures have changed, such as simple oversight in the ICU to remove Foley catheters after three days which had an immediate impact on infection reduction.   She also shared case studies that her specialized infectious disease team worked with that would break your heart.

One Health recognizes that the health of people is connected to the health of animals and the environment.  Research and industry collaboration are essential.  I was proud to have my friend see and hear the efforts that are going on in the agriculture community to make change so she will trust our food supply and want to continue to eat beef

My hope for future meetings is to include more human health professionals in our discussions.  Let’s hear what initiatives they are working on and address antimicrobial use together.

Thru the eye of an infection control nurse not familiar with USA Beef production:

  1. How do the animals get out of this chute?  How do you get them back to the pen?
  2. Why do you track “days on feet”?  Aren’t they always on their feet? 
  3. What are “check off dollars”?
  4. I have never heard of ionophores in human medicine.  What are they? 
  5. There is a lot to know about.
  6. How to the producers at the farmer’s market fit into this model?
  7. There are trade-offs. 
  8. I never thought about how we grind different animals together to make hamburgers.
  9. Antibiotic resistance is everyone’s problem.  We have a lot of examples of changes we have made in human medicine, as well as a lot of challenges this group might be interested in.