The MidCentral District Health Board faced a backlash over a tweet saying 'Don't stop when you're tired, stop when you're done' as part of an inspirational message series.

A health board that blundered by encouraging people to work through fatigue has people wondering how it could get its motivational messaging so wrong.

"Don't stop when you're tired. Stop when you are done," was the "motivational Monday" Twitter message posted by the MidCentral District Health Board.

The post aimed to give people a "little encouragement" for the start of the week, but Twitter users found it inappropriate from an organisation that deals with overworked medical staff.

STUFF MidCentral District Health Board has received backlash over a post that encourages people to work despite being tired.

MidCentral has since apologised and deleted the message, but unions say the apology rings hollow with overworked doctors, nurses and medical technicians.

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Resident Doctors' Association national secretary Dr Deborah Powell said that, even as a mistake, the tweet highlighted an "archaic" attitude towards overwork.

STUFF The "motivational Monday" post was taken off Twitter a day later.

Last year, 120 Palmerston North doctors joined a nationwide strike to protest being overworked.

Just over a year later, and nine months after reaching a settlement to end the strikes, the same rosters were still in place, Powell said.

"It shouldn't take this long to get rid of patently unsafe rosters.

123rf A Twitter post from MidCentral District Health Board aimed to give people a "little encouragement" at the start of the week, but it wasn't well received.

"This apology will ring hollow for staff on the ground. It would appear the DHB hasn't learned a thing [after the strikes]."

Powell said the roster issues stemmed from understaffing, which would still be a problem even when every position the DHB had budgeted for was filled.

In late 2016, Palmerston North Hospital was short by 41 positions, including 10 in the emergency department, and the issue of tired staff is still festering.

Other tweets in the long-running series have implored people to be kind to unkind people and advised "fall seven times – get up eight". One timed to coincide with the school holidays said "Chill! (It's only) chaos".

Association of Salaried Medical Specialists national secretary Jeff Brown, who lives in Palmerston North, said the latest tweet was "absolutely inappropriate" from a district health board, and particularly ill-timed and tone-deaf.

"It's been a hell of a winter. Staff have been going above and beyond to deal with the kind of workload that we've never seen before."

Ironically, Brown was returning from an international conference on protecting medical professionals' wellbeing when he came across the gaffe.

"The World Medical Organisation has just added an update to the Geneva Declaration. It added a duty for medical professionals to look after themselves, so they can [effectively] look after their patients."

Brown said it was important that medical professionals looked after themselves, because overwork led to more mistakes and staff burnout.

An association survey of New Zealand hospitals last November found 50 per cent of specialist doctors reported suffering burnout and were an increased risk to patients.

"The international research shows the first signs of burnout are a lack of compassion and a rise of cynicism. Those are absolutely the last qualities you want to see in our health professionals."

Brown said MidCentral may have deleted the tweet and apologised, but the statement was left to stand for 24 hours. It was going to take a lot of work to repair the damage done to the public and staff's trust in the health board, he said.

MidCentral chief executive Kathryn Cook said MidCentral genuinely regretted posting the motivational Monday tweet.

"A junior staff member posted this tweet with good intentions and we let that person down as our usual review process did not occur.

"We have apologised to all staff and this was a sincere apology."

MidCentral was committed to providing safe rosters for resident medical officers and all staff, she said.

"The annual changeover of resident medical officers occurs between now and the end of the calendar year, and we are on track to implement five of six new, safe hours rosters."

"We refute the assertion of the Resident Doctors' Association that there is a hidden gap between aiming to fill all budget roles, and the number of roles needed to meet actual demand and keep staff workloads within safe limits."

MidCentral's staff turnover was 9.1 per cent - one of the lowest in the country, Cook said.

MidCentral also wrote an apology on Twitter and Facebook on Tuesday evening.

Twitter user Ninya Maubach​ said she was alarmed by the initial post.

Maubach moved from Palmerston North to study medicine in Australia, but she follows MidCentral on Twitter in case she comes back to Manawatū.

"I might want to return to work there in the future. But a tweet like this alarms me because it suggests that hospital management has not been following the discussion developing over the past few years about protecting clinicians' wellbeing."

For staff to offer patients a high standard of care, they needed to take care of themselves first, Maubach said.

"Doctors frequently keep working long beyond the end of their shift in order to serve the needs of their patients.

"They don't need a token cliche to tell them to do this, because it is in their nature."

Twitter user Nick Phillips said the message made MidCentral look incompetent.

"I tried very hard to write the least offensive reply I could that would, with luck, lead them to realise just how stunningly inappropriate that tweet was.

"I don't want those people working when they're not in a fit state, which this would encourage them to do."

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