Abnormal respiratory rate (RR) can indicate that a patient is deteriorating, yet RR is a vital sign too often recorded inaccurately, or even not assessed by nurses. RR assessment requires more complex observation than a simple count of breaths per minute (bpm), and should include listening for rasping and looking at depth of breathing. A nurse’s judgement is important in respiratory assessment, over-reliance on NEWS2 score ranges or technology such as pulse oximeter should be avoided. Reasons for inaccurate RR recording include clinicians using a 15-second count to estimate a one-minute measurement, possibly due to time pressures in healthcare provision. Expert nurses share their advice on checking RR accurately.