What do Progress Notes and Dirty Dishes Have in Common?

What do Progress Notes and Dirty Dishes Have in Common?

If you don’t write your notes or do your dishes, you can go hungry.

Let’s face it, no one likes washing dishes or writing progress notes. They can both pile up faster than rabbits reproduce. But everyone likes it when they’re done. If the reward is so great, what keeps us from getting them done?

Progress notes and dirty dishes share a few surprising and unexpected similarities.

Both Progress Notes and Dirty Dishes Start as a Mess

• Dirty dishes: It was a great meal. But the sink is overflowing with dishes covered by scraps of food and grease. Where do you start?
• Progress Notes: You had a great session, with good interventions, insights, and progress. But you’re overflowing with observations and clinical details. How do you start to clean up this mental clutter, so it’s organized into a clear and clean note?

They are a Never-Ending Repetitive Task

• Dirty Dishes: It doesn’t matter if you clean while you cook, use paper plates, go out to dinner, or order takeout. There are always more dirty dishes to wash.
• Progress Notes: If you’re fortunate enough to have clients, you have notes. There is always another session to document.

Easy to Put Off, Risky to Avoid

• Dirth Dishes: “I’m too tired/busy/uninterested. I’ll leave this one cup for later,” turns into a kitchen full of cups, plates, soup bowls, pots, pans, and cooking utensils. One cup takes 30 seconds to wash. The day’s worth of dishes takes over an hour or more… if you’re not so discouraged that you go to bed and leave them for the next day.
• Progress Notes: A note takes 3 – 10 minutes to write. But going overtime with a client, making a phone call, taking a bathroom break, eating lunch, or just wanting some “me time” makes putting off notes seem like an attractive alternative… until you’re behind a day, a week, a month, or even a year. Recreating old notes takes more time than writing them shortly after the session.

Tedious and Boring, But Necessary

• Dirty Dishes: There is nothing glamorous about getting your hands in dishwater up to your elbows or loading a dishwasher so there is no wasted space. It’s tedious but necessary. If you run out of dishes to eat off of, you either go hungry or waste money on disposable plates.
• Progress Notes: They feel like an intrusion into the work you love. But they are necessary for tracking client progress, meeting legal and ethical requirements, ensuring continuity of care, making informed decisions, and getting paid and keeping your paycheck. My mantra is, “done is beautiful!”

The Effort is Worth the Impact

• Dirty Dishes: One dish is insignificant. When all the dishes are dirty, you have an unusable kitchen. Imagine waking up in the morning to a sparkling clean and clear kitchen!
• Progress Notes: One note might feel a drop in the bucket, but the time you spend writing your notes is useful for reflecting on your client’s journey and developing quality care.

Routine Provides Satisfying Results

• Dirty Dishes: Finding a rhythm can be soothing, almost meditative, if you do them regularly before they are a horrible chore. Washing the dishes keeps your space organized.
• Progress Notes: Establishing a routine for note writing can lead to greater satisfaction in your work and less burnout. Writing your notes keeps your mind organized.

Good Tools and a Clear Process Make for Faster Work

• Dirty Dishes: To complete the task efficiently, you follow a process: scrape, rinse, wash, dry, and put away. It doesn’t matter if you use a dishwasher or wash them by hand, there’s a specific order and formula to washing dishes. You may have a particular sponge or brush you like, a specific way to load the dishwasher, or a routine for washing by hand that makes the process quick and as painless as possible.
• Progress Notes: There’s a format that includes administrative and clinical content. The quality of the template makes a difference. A lousy template provides generic prompts like “assessment” or “clinical content.”  With 6 different assessments in a note, it’s difficult to know where to write each one. To a therapist, everything is clinical. A well-organized note provides structure and prompts, breaking down every element into clear cues for what’s needed. That’s why I created a formula to writing progress notes that makes the process quick and as painless as possible, so you don’t have to figure it out on your own.

Documentation Wizard® Clinical Forms provide a systematic structure with short narratives and checkboxes to cue you in for every element needed. They provide the organization for an effective and efficient process so you can finish your notes – maybe even before dinner.

Dirty dishes and left over progress notes may have a few things in common, but with a few good habits and tools, you don’t have to go hungry. 

Beth Rontal, LICSW, a private practice therapist and the Documentation Wizard® is a nationally recognized consultant on mental health documentation. Her Misery and Mastery® trainings and accompanying forms are developed to meet strict Medicare requirements. Beth’s Documentation Wizard® training program helps clinicians turn their clinical skill and intuition into a systematic review of treatment that helps to pass audits, protect income, maintain professional standards of care, reduce documentation anxiety and increase self-confidence. Beth’s forms have been approved by 3 attorneys and a bioethicist and have been used all over the world. She mastered her teaching skills with thousands of hours supervising and training both seasoned professionals and interns when supervising at an agency for 11 years. Her newest initiative, Membership Circle, is designed to empower psychotherapists to master documentation with expert guidance, efficient strategies, and a supportive community.