I had a similar problem, but it was the shim in the clutch. Here is a copy/paste from another forum:
"The blend doors on these trucks are electronically controlled. That being said the most common reason for poor cooling is the system being low on refrigerant, the compessor clutch not engaging, poor fan clutch performance not getting enough airflow across the condensor at idle, or the cycling clutch switch (aka low pressure switch) going bad.
To start, NEVER try to charge an ac system without a manifold gage set with both low and high side gages on it. Using those wally world one gage wonders is like flying blind. The high side pressure tells you a lot more about whats going on than the low pressure side.
Usually a ford leaks at the springlock couplings and the compressor shaft seal, random oily residue around an ac fitting is usually a sure sign of a leak and also if you see a ring of oil slung around the compressor clutch area (hood, radiator hoses, etc) thats a good sign also.
Fan clutches and poor airflow problems can be checked pretty easily if you have hig and low side gauges, when its really hot out let the truck idle and when the high side starts to really climb (250-300) spray the condensor with some water and if it drops really fast then theres an airflow problem.
The low pressure switch is pretty common also, this can be easily diagnosed by looking at the compressor hub while the ac is on and its blowing hot. If its not turning, theres a problem! First try to take the handle of a hammer and tap the hub in, if it pulls in then it needs to have a shim taken out fron under the hub. You can try to wiggle the connector and see if it comes on, be sure to check for broken wires at the switch. If it doesn't and you have adequate low side pressure (over about 40 psi should kick it on) then it should be replaced."