You have full access to this article via your institution.

The latest article from Harris and Eaton1 is a thoughtful and interesting exploration of the ways in which clinical practitioners operationalise resilience as a response to workplace stress. Yet reading this thoughtful qualitative study raises a more basic question: is so-called ‘resilience' always a healthy adaptation - or is it sometimes a silent acquiescence to dysfunction?

This is not a criticism of the participants, whose compassion and ingenuity are on display throughout. It is rather a commentary on the system wherein such resilience is being called upon. When staff routinely report working through their lunch, managing spiralling administrative demands, accepting hierarchical silos, and lacking autonomy even in their clinical decisions, we must ask: are we normalising burnout prevention strategies that mask - rather than address - more basic structural shortcomings?

The thematic richness of the study, especially the subthemes of ‘lack of autonomy', ‘pressure from patient expectations' and ‘disconnection across roles' paints a picture of a clinical workforce adeptly navigating not only clinical work but also institutional shortcomings. That some participants describe ‘switching off notifications' and ‘mentally detaching' from work not as a luxury but as a survival strategy should be alarming. In any other healthcare environment, these would be signs of moral distress, not triumphs of individual resilience.

We also need to think about the language that surrounds resilience in clinical practice. When the profession celebrates resilience as a hallmark of clinical excellence, do we risk conflating endurance with wellbeing? When a clinician stays late each night to complete paperwork or unpaid hours in the interest of patient care, is that resilience - or is it insidious erosion of boundaries and self?

The evidence also discloses worrying power dynamics, particularly in corporate and NHS settings, where clinicians are micromanaged and support staff have no voice. Where nurses report no control over their daily schedule or report they lack ‘permission' to challenge managers, these are not merely issues of communication - these are deep-seated cultural hierarchies that will not be toppled by resilience training alone.

We should take care, too, not to over-praise those who flourish in adversity without challenging the cost. Resilience should not be clinician's badge of silent suffering. Instead, we should ask if some of the adaptive mechanisms described - from emotional detachment to avoiding managerial conflict - are genuinely protective, or simply necessary armour against environments that remain sick.

Following this research, the call is not simply to help clinical practitioners become more resilient, but to reshape the clinical environment in a manner that this resilience is no longer in constant need.