Should vital signs be a routine?

This issue was raised in a Professional issues lesson and the teacher had a completely different view to my own, she believed that the observations take up too much time in a nurses day whereas I feel they are an important tool in assessing any changes in a patients condition quickly despite the time that they take up.

In England, observations and measurements of vital signs are carried out on each patient four hourly or as their condition dictates but they are very rarely omitted. However, in Finland, these measurements are only carried out if the patient needs regular monitoring and this is often only blood pressure and occasionally heart rate and oxygen saturations; observations of respiratory rate aren't routinely carried out. 

As a paediatric student nurse, I know how quickly a child can deteriorate and the measurement of vital signs along with observing visual signs such as change in colour, altered disposition and work of breathing can be the difference between life and death. Although, it could be argued that the visual signs are much more important as often with very sick children their bodies compensate so much that changes in vital signs are very late.
Parents of children may find it comforting and reassuring that these measurements are being done and by them being carried out on all the patients, it ensures that parents don't feel their child is less of a priority despite this sometimes needing to be the case depending on the severity of their child's illness.
There is the obvious issue of time and money and a current debate that has been on the news is whether nurses are caring, a suggestion is that by omitting vital signs for patients that don't necessarily need them may leave more time for a nurse to be 'caring'. 

In conclusion, in my opinion, measurement of vital signs should remain as a nursing duty or routine despite the negatives that are mentioned above. They can help to discover a deterioration in a patients condition quickly and also can help to notice an improvement.

Can my experiences of culture shock help me to develop my nursing practice?

Culture shock isn't only brought on by a change in country or language, it could be argued that parents of a sick child may experience a degree of culture shock when their child is admitted to hospital. The hospital environment can be classed as a 'culture', there are certain attitudes and behaviours that medical professionals may subconsciously expect from patients and their families and if these aren't adhered to the family may be looked upon as causing problems for staff, when this may not be the case.

The hospital environment may be completely new and this accompanied with the equipment, medical jargon and the stress of their child being sick can be an extremely challenging time. As a childrens nurse it is important to not simply assume that parents have a previous knowledge and understanding of hospital admission and everything that comes with it, although this will be the case for some patients and their families, it is essential that this is not taken for granted.

More open communication and reassurance by paediatric nurses can go a way towards alleviating the feeling of 'culture shock' in hospital.