I interned at a program for DD clients and was really impressed by the notes the psychiatrist wrote. They were detailed and full of useful information. She wrote them in session and always printed off a copy for the client (or his/her guardian).

I work as an RN at a psych hospital now and have to write 6-8 patient notes each day. They are quite brief as I don't have time to write extensively. I include a section on what the patient tells me and use direct quotes. I also must include my clinical impressions, for example patient affect. I also report on intent to self harm, thoughts of death, hurting others, delusions, etc. And I report on patient behavior, ability to self soothe, coping suggestions made to patient, if patient is participating in the program, if patient was disruptive, cooperative, insightful, etc. I think the notes are indeed pretty boring but they can help the staff on the next shift or the next day get a more complete picture of the patient if need be. The therapist notes are based on a session rather than observations made continually throughout the day, so they can be different--more limited like a snapshot in time, but also deeper and longer. The MD notes are yet another creature. All the notes from the different staff help add up to a more complete picture. The notes may be reviewed by county social services if any issues are raised. I think if I were doing outpatient work, a big function of my notes would be something I could quickly review before seeing the client at the next session to remind me of where we were at.