Hospital Chaplaincy – Behind the Curtain
fA hospital chaplain’s role is to provide spiritual care and guidance to patients and staff, but their vocation extends far beyond counseling. Iredell Health System is fortunate to have Reverend Allison (Bubba) Simmons, MDiv, serving as chaplain and director of pastoral care, but her childhood dream was that of a different role in medicine.
“When I was younger, I thought I wanted to be a doctor,” said Simmons. “I loved the TV show ER. Toward the end of high school, I decided it wasn’t exactly for me. It wasn’t until college that I started working in a church and knew I wanted to work in pastoral care, but I thought it would be writing church curriculum. That’s why I went to seminary. While I was in seminary, I took a pastoral care and counseling class, and it all clicked.”
Chaplaincy marries two of Simmons’ passions.
“The hospital gives me the clinical side and the staff and patients give me the parish side.”
A chaplain’s role encompasses spiritual counseling, advance directive planning, and crisis management. It differs from traditional ministry since chaplain’s are specially trained in clinical pastoral care. Simmons completed her chaplain residency at a large health system, but working at Iredell Health gives her a unique advantage.
“If you’re in a larger organization, most of what you’re doing is crisis management and building relationships with staff. I didn’t get to follow the same patients because they would get moved to floors that weren’t in my area. Iredell has given me the chance to build upon patient relationships because I often get to see them a few times in the hospital or throughout their course of treatment.”
Although Simmons is an ordained minister through the PC (USA) church, her role as a chaplain is focused on the personal spiritual journeys of her patients and colleagues.
“When I walk into a patient’s room, I often don’t know what their theology or spirituality of origin is. I work within their spiritual framework because, when they leave the hospital, they’re the ones that have to continue their journey — whatever that may look like.”
If someone needs spiritual care outside her scope, she serves as the catalyst to get them the care they need.
“We rely a lot on our brothers and sisters in other denominations and other groups to come and administer care, especially outside the bounds that I can provide. For example, I’m not Catholic, so I would not administer sacraments. I’m not Jewish, so I would rely on my Jewish friends to bring something Kosher for my patients.”
Over the years, Simmons has outfitted the hospital chapel with several items from different theologies including prayer rugs and religious texts such as the Bible, the Book of Mormon, and the Qur’an. She is an advocate for inclusion and works to ensure everyone who visits is supported.
Simmons uses philosopher Martin Buber’s “I-Thou” method. In an I-Thou relationship, each party meets the other where they are and genuinely cares about the other.
“I pick up on things that are said or unsaid and say, ‘Tell me more,’ or if they start to get tearful, I say ‘Tell me what your tears are saying.’ I follow where they lead and follow alongside them.”
Part of Simmons’ role is crisis intervention. She often assists with communication between clinical staff and the patient or their family.
“A lot of what I do is communicating between the patient, their family, and the clinical team. I may say ‘I’m not clinical, but I can help you understand what’s happening.’ I introduce the care team and let them know they’re all there to take great care of them or their loved one.”
Simmons holds several memorable stories close to her heart, but one in particular sticks out.
“There was a patient during the height of COVID who was waiting for his friend to arrive. He chose not to be intubated and was coming off the BIPAP and allowing himself to pass peacefully, but it was going to be four hours before his friend could get there. He was scared. I sat in the room with him on that BIPAP and held his hand and talked to him while he rested and waited for his friend. It was so meaningful that he wasn’t sitting there by himself.”
Much of Simmons’ responsibilities involve death and dying, but she finds reward in helping others navigate unfamiliar territory.
“Death is an uncomfortable subject for most people, and that’s the majority of what I’m working through — letting people sit in the uncomfortable and express how they feel.”
When asked if death gets easier for her as time passes, the answer is simple — no.
“When I first became I chaplain, I was a newlywed. Watching older couples say goodbye after 60 or 70 years of marriage were some of the hardest deaths I went through. When I became a mother, infant and child deaths were the hardest. Then I experienced my own miscarriages and that made it hard as well. Now, I’m in a place where my parents are getting older, and I see people losing their parents. It’s difficult for me because I’m an only child. Every season is different.”
Simmons is not only available to patients and their families, but also to Iredell Health staff.
“I’m here for staff emotional and spiritual support. It could be anything from helping them care for a dying patient when they have recently lost their own loved one, to helping a new nurse or CNA cope after experiencing their first death and they weren’t prepared for all the emotions that come with that. I’ve counseled some staff on how to approach a patient who doesn’t see eye to eye with them, but they want to continue giving them the best possible care. Sometimes, employees need to talk about normal everyday stressors like their kids driving them nuts at home. Usually at that point, I know their theological language and can go from there.”
Part of chaplaincy is caring for employees, but they are also what motivates Simmons to keep going.
“They love their jobs and care about their patients. It keeps me motivated to keep achieving and pushing forward because we are in this together. I also have great family support and surround myself with people who make me laugh and who challenge me.”
Simmons, a parent of three, sees value and practices empathy in even what seems to be the most mundane conversations through the eyes of her children.
“Being with my kids brings me back down to see the importance in the minutiae of life. I may have sat and held the hand of someone who was dying, but they didn’t. Someone not showing up to practice may be dire and drastic to them, and that brings me back to the importance of the small things. I don’t discredit their feelings or compare, because their experience is just as valid for them as mine is to me.”
For those that haven’t met Simmons, or Bubba as she prefers, she is not what you’d consider an “ordinary” chaplain. In a male-dominated field, she is a boisterous female and what some would call “unfiltered.”
“Growing up as a millennial female, there was a lot thrown at us as young girls to not like who we were. I heard ‘you’re too loud’ or ‘you’re too much’ constantly. Over time, I understood that ‘loud and too much’ is who I’m called to be. Part of being a chaplain is being an earth shaker and a system shaker and not being afraid to ask the hard questions.”
This further proves Simmons’ philosophy of meeting people where they are.
“I’ve learned to love all aspects of my personality whether it’s Allison that comes out in the pulpit or Bubba that comes out at the bedside or goofy mom or friend, or the friend that challenges you and makes you think differently. I am who I am, and God will use me as he sees fit.”
Simmons’ role as chaplain is far from predictable, but she uses it as an opportunity for growth.
“Change is a core value of mine. No matter what theology or spirituality you believe in, the most consistent thing that happens is change. I believe in my theology that if I’m not changing, then I’m not getting closer to the divine. God is not going to call me to stay the same.”
If you’re ever at Iredell Memorial Hospital, say hello to Bubba. You’ll be glad you did.
