Elizabeth Croton explains how she would tackle this complex situation:

Claire chose her first house job because she really clicked with the Christian consultant. Unfortunately, things have changed recently. The consultant has become part-time, now only covering outpatients; Claire no longer has regular contact with him. The new locum ward consultant is unapproachable and impossible to please. Even worse, Claire's SHO sits in the mess 'supervising' Claire doing all the work: she issues orders rather than requests and never says please or thank you. Whenever Claire makes a mistake, the SHO has a good laugh about it with everyone else in the mess. Claire bursts into tears during house officer teaching, blurting out that her SHO is horrible to her. Rumours start. The SHO accuses her of bitching and then tells their Christian consultant that Claire is incompetent and difficult to work with! Claire has now lost all her self-confidence and feels inadequate as a doctor. She also feels a bad witness: she should be turning the other cheek, not grumbling. What should she do?

Elizabeth Croton is a surgical SHO in Birmingham:

I detect a murmuring of 'I've been there!' This scenario contains familiar elements that we've all faced. There are several issues here. Firstly, Claire is disappointed: two difficult bullies have replaced her idealised Christian consultant. Next is the issue of malicious gossip that, like MRSA, thrives in NHS culture and takes innocent victims. Thirdly is the issue of work-related stress: events have snowballed, resulting in Claire's tearful breakdown. Lastly is the guilt issue. Tiredness and fragmented Christian connections make us forget that we are 'works in progress'. We often beat ourselves up regarding our own failings.

Disappointing fellowship

Regular fellowship with other Christians, particularly senior colleagues, can be immensely comforting.[1] Sadly, this is not usually the case and we can really feel for Claire, being landed with these two difficult individuals instead.[2] Although often surrounded by his disciples, Jesus did spend time in solitary communion with his Father; think of his time of despair on the Mount of Olives.[3] Although Christians are sometimes without fellowship, we are never alone.[4]

Gossip

Gossip is such fun! Christian or not, we all love a good nugget of another's misfortune. Why else are chat shows like Trisha so popular? Still, it's not godly behaviour. Proverbs hits the nail on the head: 'A gossip betrays a confidence' but 'Without gossip a quarrel dies down'.[5] Hospital gossip is infectious: it reaps havoc and wrecks relationships. A Christian's best defence is to not partake. We need the Holy Spirit's power to be salt and light.[6]

Stress

Claire's breakdown illustrates the 'put your head down and get on with it' NHS mentality. Nipping problems with difficult colleagues in the bud is hard. Constant activity and ongoing stress can lead to such outbursts: do you remember Mary and Martha?[7] Stress is common but too much is detrimental. We all struggle in recognising when enough is enough. We should heed Jesus' advice: take time out and get some rest.[8]

A bad witness

We have clichéd ideas of the perfect Christian: a witnessing expert who faces injustices and trials with a cheesy smile! We can all sympathise with Claire's guilty feelings, which reflect her humanness and weakness. Yet she is allowing the Devil to gain a foothold.[9]

What now?

What should Claire do now? Could she get the rest of the day off and spend time praying with Christian friends?[10] She needs sound godly advice on managing this situation in a Christ-like manner.[11] She should approach her educational supervisor for help; could she take time off work, away from the situation?

It would be wise to talk to her Christian consultant as he is senior, knows Claire well and already involved. Could he act as a godly arbiter whilst they air their grievances and find a solution? Some new SHOs find having their own juniors very difficult. Claire's SHO may not even know that her behaviour is unacceptable! Also, it is important for Claire to examine herself as well. It is easy to blame her SHO but there may be aspects of Claire's personality and habits that are irritating, leaving her partly at fault. If I were Claire's consultant, I would also encourage her to develop a more resilient character. Consider the biblical example of wearing our spiritual armour in the expectation that life will be tough.[12] We must persevere through it, knowing that it is producing a stronger Christian character.[13]

Depending on how things go, it may be possible to continue with the firm's current working arrangements. At an appropriate stage, both Claire and her SHO should be encouraged to offer forgiveness wherever appropriate; from Clare's side, this is Christ-like and an important witness.[14] Sadly, reconciliation may be impossible, leaving no alternative but to work apart.

Whatever the situation, it is important for Christian juniors to have godly mentors who can act as sounding boards for problems and pray through any issues that arise. CMF runs a pastoral care scheme for junior doctors, matching them up with local more senior members. I would encourage every CMF junior to make use of this service.[15]