Thesis Research - Contention in Healthcare

Posted on: October 15th, 2011

Disorientation in health care is often blamed on factors such as rigid constraints mandated by doctors and nurses on locations of nurses stations, hallways, machines, patient rooms and medical equipment due to a need for hyper efficient accessibility. The psychology of the patient and the family is rarely considered as a design factor in space planning. This results in healthcare facilities that are nearly impossible to navigate due to labyrinth-like layouts, an abrupt lack of interiority expressed on the exterior façade, exposed equipment making the sense of the space more like a torture chamber than a healing respite, and an overall health typology that relates nicely to a prison.

Beyond factors of physical space both disorienting and diminishing patient healing there are slight cues that contribute to loss of a sense of self. Patients are entirely cut off from the outside world, usually constrained in even opening a window. The sterility of the environment cuts the patient away from the natural world leaving them in isolation with only themselves and their memory of their identity – further diminished by inconsequential meetings with care takers creating a new position of infantilism in perhaps a once fully-functioning member of society. Constant open doors and glass door treatments strip a patient of the simplist right to privacy and are not dissimilar to the fourth wall in theater, creating a spectacle of the patient room.

Reorientation in healthcare spaces will require both enhancing basic architectural moves and rethinking the philosophy of health management that reintroduces a mental well-being and a relationship to nature to physical healing. Patients are neither numbers or experiments and must be considered in the basic idea of health, safety and welfare. It is giving up to say that we can not change health care facilities in a structural and conceptual manner that redefines the typology. We are able to move beyond contrived applications of clouds painted over a light that a patient is forced to stare at for hours waiting for the next treatment.

This relates to the basic studies of disorientation because one must understand the nature of the beast before raising a sword, and the antidote to this lies in the antithesis – orientation. Knowing and understanding both architectural and psychological means of orientation and disorientation will lead to a new understanding from a different perspective of rehumanizing a space that has long ago ceased to consider every aspect of humanity. This understanding not only applies to healthcare but also to other typologies such as retail, urban planning, correctional and transportation facilities.

We must understand that we are contributing to the zeitgeist, an overall sense of loss. We have lost our sense of self somewhere along the way – between roads that turn us in circles and cyberspace that sweeps us out of our physical reality. We are lost individually, collectively and nationally. We are lost because there are forces in the world that have removed us from what we naturally understand and created divides that keeps us from being able to orient and align ourselves with the natural world. We as humans need spatial leadership and orientation – we need horizons, light and darkness, a predictable natural order and clarity. Whether realized in a rehabilitation center, ICU, Casino , shopping mall or prison the conclusion will inform spaces of healing and orientation.