I also, as a nurse, have a habit of coping the chart notes and sending these into their PCP to REALLY show an MD that there is a real probelm! Sometimes the chart notes are the only way to prove that there is a probelm, vs say...the family saying nothing is wrong or blaming the staff (or an MD thinking...they just don't want to deal with them!)!
Every time I have sent in the chart notes, I have gotten results. See if this is possible in your facility (some have disclosure rules to contend with..even though an MD is allowed to see any documention about their patients!).
Also, don't forget some non-pharamlogical implementations to help quell behaviors. Like quiet dim room (not dark...just a little dimmer to quell overstimulation by too many lights). Music the resident likes...I find this one works wonders (avoid loud or fast paced music though). Offer a beverage or snack. Sit at a safe distance and try to have a nice conversation...make sure you sit, some people get aggressive because you are up above them in a dominient stance. Actively listen, sometimes they will say they are feeling overwhelmed and you can document that in quotes and either keep on trying alternative implementations to quell..or a prn medication for anxiety.
I have had residents that actually freak out more with quiet darker rooms, and like to keep themselves busy! We have soft squishy balls for residents to squeeze if they are anxious (and they don't hurt so much when they are hucked at you!), or we also had some envelopes that we had some residents help us sort away (all fake of course, but they feel productive and that helps!). Or we have had residents help with bed making, folding towels, things of that nature to help them feel helpful and productive!
Also, watch sleep times. Many residents don't know what time of day it is even if they look outside and see light/dark. So many oversleep during the day and are very anxious and awake at night. Trying to establish a good sleep pattern really can help! We also try really hard to keep residents busy doing activites so they are tired for bed at night! With the older residents we find BINGO really is a good game, and you can help assist them with playing..and it can be quite fun too!
We also have people come in or even CNA's that will read the paper to everyone in a nice room (we have one with a fireplace and lots of comfly recliners...this is a very popular routine in my residents daily life!). And we have this CNA that is an excellent story reader and reads a book to them twice a week! We also have bell choir and this can be done by just about anyone
Just some suggestions of things we do...
And yes, if you are injured by a resident you can press charges against them if you are physically harmed and you can prove it. When my staff gets injured I send them into an urgent care clinic or to their MD or even ER to have it documented for legal purposes, as well as for workers comp cases if needed. Nothing will get a admin going than a few workers comp potentials or documented cases of staff abuse!!!!! (again make sure before you go you charted EVERYTHING..that way they can't easily blame you for your injury!).