Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialties with differing levels of prescription 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 of physicians, 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 the postwar period, nurse education has undergone a process of diversification towards advanced 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.
Dereham (/ˈdɪərəm/), also known as East Dereham, is a town and civil parish in the Breckland District of the English county of Norfolk. It is situated on the A47 road, about 15 miles (25 km) west of the city of Norwich and 25 miles (40 km) east of King's Lynn.
The civil parish has an area of 21.51 km2 (8.31 sq mi) and, in the 2001 census, had a population of 15,659 in 6,941 households; the population at the 2011 census increased to 18,609. Dereham falls within, and is the centre of administration for, Breckland District Council. The town should not be confused with the Norfolk village of West Dereham, which lies about 25 miles (40 km) away.
Since 1983, Dereham has been twinned with the town of Rüthen in North Rhine-Westphalia, Germany. It is also twinned with Caudebec-lès-Elbeuf, France. In spite of the reunification of Germany in 1990, the sign on the A47 at the entrance to Dereham from the Swaffham direction still refers to Rüthen being in West Germany; this sparks periodic comment in the local press.