I see a lot of threads about HOW to count respirations. That is not my question. My issue is with inaccurate counts in the documentation. Like, flat out falsified/guessed/not actually counted. Seeing 18 as the respiration for the last 12 hours in a patient who is having moderate distress is just wrong. I went in after seeing those vitals. I counted 40. And not long after was taking him to the ICU anyways. The ICU nurses probably saw the trending vitals and think we're idiots. I don't see a real solution to this. How could this be improved? If I go behind and document the actual respirations then it'll look like 18-35-18-32-18-40, etc. Which is ridiculous looking.