Nursingis a profession within thehealth caresector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health andquality of life. Nurses may be differentiated from otherhealth care providersby theirapproach to patient care,training, andscope of practice. Nurses practice in manyspecialtieswith differing levels ofprescription authority. Nurses comprise the largest component of most healthcare environments;but there is evidence of international shortages of qualified nurses.Many nurses provide care within the ordering scope ofphysicians, and this traditional role has shaped the public image of nurses as care providers. Nurse practitioners are however permitted by most jurisdictions to practice independently in a variety of settings. Since thepostwarperiod, nurse education has undergone a process of diversification towardsadvanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient's family, and other team members that focuses on treating illness to improve quality of life. In the United Kingdom and the United States, advanced practice nurses, such as clinical nurse specialists and nurse practitioners, diagnose health problems and prescribe medications and other therapies, depending on individual state regulations. Nurses may help coordinate the patient care performed by other members of a multidisciplinary health care team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Birmingham (/ˈbɜːrmɪŋəm/ (About this soundlisten) BUR-ming-əm) is a city and metropolitan borough in the West Midlands, England. It is the second-largest city, urban area and metropolitan area in England and the United Kingdom,[b] with roughly 1.1 million inhabitants within the city area, 2.9 million inhabitants within the urban area and 4.3 million inhabitants within the metropolitan area and lies within the most populated English district. Birmingham is commonly referred to as the second city of the United Kingdom.
Located in the West Midlands county and region in England, approximately 100 miles (160 km) from Central London, Birmingham, as one of the United Kingdom's major cities, is considered to be the social, cultural, financial, and commercial centre of both the East and West Midlands. Distinctively, Birmingham only has small rivers flowing through it, mainly the River Tame and its tributaries River Rea and River Cole – one of the closest main rivers is the Severn, approximately 20 miles (32 km) west of the city centre.
A market town of Warwickshire in the medieval period, Birmingham grew in the 18th-century Midlands Enlightenment and subsequent Industrial Revolution, which saw advances in science, technology, and economic development, producing a series of innovations that laid many of the foundations of modern industrial society. By 1791, it was being hailed as "the first manufacturing town in the world". Birmingham's distinctive economic profile, with thousands of small workshops practising a wide variety of specialised and highly skilled trades, encouraged exceptional levels of creativity and innovation and provided an economic base for prosperity that was to last into the final quarter of the 20th century. The Watt steam engine was invented in Birmingham.
The resulting high level of social mobility also fostered a culture of political radicalism which, under leaders from Thomas Attwood to Joseph Chamberlain, was to give it a political influence unparalleled in Britain outside London, and a pivotal role in the development of British democracy. From the summer of 1940 to the spring of 1943, Birmingham was bombed heavily by the German Luftwaffe in what is known as the Birmingham Blitz. The damage done to the city's infrastructure, in addition to a deliberate policy of demolition and new building by planners, led to extensive urban regeneration in subsequent decades.
Birmingham's economy is now dominated by the service sector. The city is a major international commercial centre and an important transport, retail, events and conference hub. Its metropolitan economy is the second largest in the United Kingdom with a GDP of $121.1bn (2014), and its six universities make it the largest centre of higher education in the country outside London. Birmingham's major cultural institutions – the City of Birmingham Symphony Orchestra, the Birmingham Royal Ballet, the Birmingham Repertory Theatre, the Library of Birmingham and the Barber Institute of Fine Arts – enjoy international reputations, and the city has vibrant and influential grassroots art, music, literary and culinary scenes. The city will host the 2022 Commonwealth Games. Birmingham is the fourth-most visited city in the UK by foreign visitors.