May 2024

By Jeannine Moga, MA, MSW, LCSW

Working Upstream: What It Means (And Why It’s Important)

In this VETgirl online veterinary continuing education blog, Jeannine Moga, MA, MSW, LCSW talks about working upstream and what it means. Working upsteam describes work, paid or unpaid, that addresses issues closer to the source/s of a problem.

The vast majority of healthcare professionals work in environments focused on downstream impacts. Even when advocating for prevention – or working in primary care – an enormous amount of energy is directed toward ‘downstream’ issues like illness, injury, and the like. All of this is important work and worthy of our best efforts. To do it well, it is essential that we sustain ourselves for the long haul.

The challenge, then, comes from the reality that veterinary systems are overwhelmed. Whether the overwhelm is coming from burgeoning caseloads, evolving client expectations/demands, workforce shortages, or myriad other industry (+ social, economic, and environmental) factors, we also know that the overwhelm can’t help but take a toll on us – individually and collectively. However energizing our work may be, each one of us is leveraging a finite amount of energy that must be regularly, and intentionally, restored.

giving two hands

Image by Shameer Pk from Pixabay

And here’s where “working upstream” comes in. Working upstream can be defined in several ways, with nuances specific to the field or industry. Within the boundaries of this blog, though, I use the term to describe work, paid or unpaid, that addresses issues closer to the source/s of a problem. Working upstream gives us a break from the strain of downstream problems while also providing us with an opportunity to use different skills – or to wield our best skills in a different way. It is good for the brain (and often the body and spirit) to change things up. Upstream work can be intensely creative and hopeful! As such, it can also be incredibly regenerative and is a critical tool in the self-care toolbox.

What are some examples of “working upstream?”

I was reminded of this recently when chatting with my horse’s veterinarian during a barn call. She mentioned that she loves – LOVES(!) – teaching. Her teaching work with technicians and veterinary students is rewarding in countless ways. This is upstream work at its finest: influencing the growing minds and skillsets of our future colleagues, plus sharing a passion for animal health and wellbeing that is positively contagious. I know that teaching is not everyone’s passion, of course. For this provider, though, it fills her bucket in a way that also informs her practice.

On a personal level, while I teach (love it) and volunteer in multiple capacities (also great, but sometimes quite draining), I recently noticed that I have felt more depleted – and for longer periods – than is optimal for me. I had a sense that burnout might be taking hold. I started looking for an opportunity to do more upstream work in my limited spare time, hoping that switching things up would re-energize me on both a personal and professional level. Given that I, too, am a busy professional caregiver with a full life, any upstream work I choose to engage in must: 1) be delivered on a schedule I can control, 2) involve activities that are inherently fun, 3) require virtually no emotional labor, and 4) elicit a “H*** yeah!” response when I am asked to contribute. What might that look like, you ask? Depending on your interests and bandwidth, you might consider:

*Working in a community garden
*Driving for Meals on Wheels
*Giving your time to young people (the Boys & Girls Club and 4H come to mind)
*Giving a guest lecture to local students
*Mentoring early career professionals

Thanks to the same veterinarian mentioned above (shout out to Dr. Cathy!), I found my “upstream” through a community-building organization that connects home cooks to local families that need a hot meal they don’t have to purchase or prepare themselves. I love to cook – it settles my brain to work with my hands – and I love the idea of helping others through food.

This, to me, feels like the best kind of upstream work: I get to bake lasagna once a month, dropping it on the doorstep of someone for whom a hot meal feels like a hug. It’s community care with no expectations and no strings attached. And it fills my tank.

I encourage you to fill your tank in whatever way sustains you.

And if you’re curious for more information on Lasagna Love, visit


Image by Angelo Rosa from Pixabay

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