Janane Hanna

Putting nurses at the heart of palliative care through education at every level

As recently as 2008 there was no palliative care provision in Lebanon. Twelve years on, and thanks to Janane Hanna and other colleagues with the same vision, the country now boasts a hospital and community-based palliative care service.

Her overwhelming passion to help make the journey as good as it possibly can be for both patients and their families, has driven Janane not only to create these services but also to develop training for both nurses and doctors across the region and promote the value of palliative care and nursing in the media. All this while she continues her day job as a pain and palliative care Clinical Nurse Specialist at the American University of Beirut Medical Centre.

Janane’s story

“Florence Nightingale nursed in a time of crisis and we are in a very similar situation. For me, 2020 has brought out the essence of nursing.”

Janane followed her mother into nursing but insists that she definitely had no parental pressure to take that path. An interest from an early age in medicine, combined with a desire to help people and an impatience to start work in the field as soon as possible meant Janane went into nursing – initially in oncology. “I love oncology as I felt it captured the essence of nursing and I was inspired by the art of nursing through holistic care not just medical care.”

During an internship in the US, she witnessed palliative care for the first time and returned to Lebanon inspired to create the guidelines and recommendations for a palliative care service there. An introduction to a doctor and a nursing colleague with a shared dream saw the trio start a community-based service. In 2010, The Lebanese Centre for Palliative Care, Balsam (meaning soothing), was born. Three years later, the same group of enthusiastic professionals, armed with proof of concept then established the first acute hospital-based service, well ahead of Janane’s ten-year goal.

Janane’s main job now is in the American University of Beirut Medical Centre as a pain and palliative care Clinical Nurse Specialist where she cares for adults and children and coaches colleagues. Not content with establishing and embedding quality palliative care in her home country, Janane is now also training and upskilling professionals across the region. Most recently, she has developed a pain course for Dubai and currently she is working on an e-learning programme for palliative care.

What drives you to make a difference?

“I’ll never forget when I told my Dad I was going into palliative care. He looked at me as if to say, ‘why?’. Firstly, I had to explain what it is. Then he said he couldn’t understand why I wanted to go into a speciality where everyone will die and why did I want to bring tragedy to myself.

“But to me, we are all affected by these experiences and if I feel like I can make a difference in this experience for the patient and the family and the family is okay afterwards – that is what keeps me going. If I see the family a few days after and I know the journey was smooth, that gives me the confidence to know I have done the best I can and I immediately feel energised and ready to start caring for the next patient.”

How do you inspire others through your leadership?

Janane is a real ambassador for the nursing profession as she advocates for the advancement of nursing science and palliative care practice in Lebanon. As a campaigner for change, she has been a host on several national TV shows to raise public awareness as she drives to improve public awareness of palliative care.

In the many presentations Janane gives, there is one quote she always uses at the very end. She says it echoes her philosophy and reason for being a palliative care nurse as well as encapsulating the essence of palliative care for people unfamiliar with its true meaning.

“I first heard this quote years ago and was fascinated by it, so I went and googled it and found it was by the writer, Hellen Keller, who could not see or hear. She said: ‘There is a lot of suffering in life, but there are a lot of ways to decrease the suffering’. And I always remind myself of that and think about what suffering I can decrease as well as encouraging other people to do the same thing.” This is the message she wants colleagues to embody.

Like many in the profession, Janane regards nursing as much more than a job. “I always say that I believe nursing is a mission and not a job. If you don’t have that passion for care and helping people in your heart, then it’s not a career in which you will want to advance.”

How can nurses play a bigger role?

“When Covid-19 struck I thought, ‘oh there goes the 2020 nursing celebration’. But then I reflected that it’s just an even more challenging year for nurses as we have to be the nurse and take care of our families and our own wellbeing. I now feel it means it’s the most perfect year for nursing. There’s even more weight put on our shoulders and we will have a lot of stories to tell our children about how we faced the challenges. This is what Nightingale was all about and this is what they bombarded us with when we went into nursing. For her it was a time of crisis and we are in a very similar situation. For me, 2020 has brought out the essence of nursing.”

Not content with practising, developing new services and building training programmes, Janane has also become the face of nursing and palliative care nursing in Lebanon. “I have been asked by the Order of Nursing to present nursing in a good way. It has given me the opportunity to talk about speciality nursing on the ground and to encourage people to pursue a career in nursing. Too many people here just think of nurses as the people who give you an injection.”

As well as promoting the profession to the public, Janane is passionate about ensuring nurses have the right skills and places huge faith in the right training. “Currently in Lebanon we don’t have standardisation in nurse training and my next goal is to bring about that standardisation. People think that practice is what makes a good nurse, but you really need the right education and knowledge. I would love to see more clinical nurse specialists here – that is my dream.”

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Janane Hanna
Balsam-Lebanese Center for Palliative Care
Beirut Lebanon