Look up the s and s of sleep deprivation--it might apply to you.
If your bosses have bosses, let them know the situation in ER. Ask for a meeting w/the CEO, or whomever, and ask him/her if you can be held responsible for "therapeutic misadventures" that are inevitable under these circumstances. Be sure you have hard data--how many nurses were on, who many pts. were seen, if you had to go on bypass, how many nurses have had to work doubles, double-backs like you described. Are you down positions? Can you get travelers? The concept would be to solve staffing issues by having more staff available.
When we were desperate earlier in the year, our managers established an "in-house" registry--regular staff nurses who would come in for 1/2 or full shift @ time and a half or even double time. They could split a shift if they wanted. It's not as tiring to work an extra shift if it's only 6 hours long. They went thru a registry, the money came out of a different budget "pocket". I would think the hospital would have an emergency fund set up to deal w/severe shortages. That's what this is.
Be sure to TELL management that they need to come around once in a while, and take some heat from the staff, and reward them for "above and beyond". Sending in pizza once in a while wouldn't hurt. People are dedicated, but it helps to be appreciated, out loud, in public, in writing! I once got a "Thank You note from the D.O.N. for working a double! Probably will never happen again, tho.
Wish I could come help, but the commute's a bit much; I don't even have snow tires anyway! Not to mention, I kinda have a personal rule about no pts. over 15#s!
Chin up, Rick, football season is almost over!!