Silence is a Design Choice: The Intersection of Critical Care and Hostile Architecture

Silence is a design choice. So is hostility.

I don’t think enough people realize: Silence is a design choice.

It is a calculated, planned measure woven into the function and form of a space. In the intensive care unit (ICU), we promote quiet times because healing is heavy work, and it is sacred work, led by the patient. Whether that healing looks like transitioning out of this life or onto it’s next chapter. Though we provide the necessary tools to support the body during this time, it is the patient’s pathophysiological, spiritual, and physical condition that determine what ‘healing’ means. We as critical care nurses do our best to support them through the process of whatever that looks like for them. Quiet times with no visitors and minimal interruptions create a space for the heavy work of healing or transitioning.

Park Benches and Public Health: The Heavy Work of Transitioning

Empty park benches invite heavy hearts to sit, reflect, and exist. They are the community’s point of transition. Park benches are planned spaces for processing and place-holders for the next person’s story…a repository for pain, pleasure, peace and long pauses.

Temporary stops; transition spots…the healing place before venturing into life’s next unknown.

Hostile Architecture: When Exclusion Becomes a Design Element

Which is why policing park benches through hostile architecture is the antithesis of their holy work. In urban planning, hostile architecture is anything designed to disrupt ‘unsavory’ uses of a thing; what this looks like, is spikes on ledges to prevent birds from gathering, dividers on park benches to prevent persons from sleeping, narrow ledges, and slanted surfaces. It is defensive design. Park benches with armrests dictate what bodies qualify to occupy space in public environments, very similar to the “you must be this tall to ride the ride” signs at amusement parks. Rarely are they designed with the needs of larger bodies in mind. Hostile architecture is an extension of exclusionary zoning, designed to prevent certain groups from dwelling in certain places, much like steering, redlining, minimum lot sizes or spatial injustice in cities.

Herein lies the irony: in environments designed to be spaces for respite and healing, such as in intensive care units and public parks, hostility towards users of the space becomes an element of design. Nursing burnout remains high, and too often nurses face violence in the workplace. Nurse mental health is a public health issue, and the emotional exhaustion in nurses cannot be underscored. ICU work environments are notoriously challenging.

When spaces are designed to be hostile to the vulnerable, there is no surprise when those same spaces become uninhabitable.