Understaffing, too much to do in the time allotted, the paperwork is piling on, and once it's done it gets picked apart; or if you forget one note because you're on a 12 hour shift by yourself with 9 clients, you're "spoken to". I honestly don't think the 'higher ups' actually read the notes - they just check to see if the quantity of notes they want got done. You don't get to spend the time needed with the client, which is the reason we're supposedly here in the first place, isn't it? I also believe the 10 to 15 minute appointment with a psych nurse practitioner every 4 to 6 weeks is only done for the procurement of medication. Most of these clients don't have a therapist to talk to, so once again, you're relying on the input of the overworked staff to let you know a client's current actions, behavior toward others, etc. in order to prescribe medications for them. And let's talk about 'respite' clients. We have one that's been with us since March - and it's now October - that's five plus months. We had heard the client would be leaving July 1st, but that obviously did not 'work out', for whatever reason.
