When she thinks back on it now, it feels like a dream.

More like a nightmare, really.

Anna Leviyeva, 34, was on the front lines of the local COVID-19 crisis this summer as an intensive care nurse at Bakersfield Memorial Hospital. When she first spoke to The Californian in late July, the number of hospitalized patients had reached its peak and the stress of the surge was mounting. Memorial Hospital had two intensive care units solely dedicated to COVID-19 patients.

In the weeks that followed, Leviyeva recalled, so many of them died.

"Some of them had been there weeks and they were fine. And then all the sudden they’re on a breathing machine and we’re putting chest tubes in because their lungs were collapsing and then they just pass," she said. "I hope I never have to see anything like that again. It was tough."

She recently opted to drop her hours at Memorial and is now working as a travel nurse at a hospital in Los Angeles where there are no COVID-19 patients.

For the nurses, doctors and other health care workers in local hospitals, the summer of 2020 is likely one they will never forget.

On July 21, the number of people hospitalized in Kern County with a COVID-19 infection peaked at 280. Three weeks later, the number of COVID-19 patients in intensive care units hit a high of 87.

And during the seven-day period from July 31 to Aug. 6, 58 people died from the virus, more than at any other time since the outbreak began in March, according to available data form the Kern County Pubic Health Services Department.

Far fewer COVID-19 patients are in the hospital today. The total last week for Kern's 10 acute care hospitals was around 60 patients total. Bakersfield Memorial, which at its peak had 16 or more COVID-19 patients in intensive care units, has just one or two in the unit these days.

“When you think back, when this is over and we look back, I think we’ll see how much this impacted our lives,” said Terri Church, chief nursing officer at Bakersfield Memorial, who oversees about 800 nurses and 400 support staff.

Church expects that if there is another surge in COVID-19, it won't be quite like the crash course that hospitals and their staffs experienced this summer because a lot has been learned in the past few months. There are better protocols and treatments in place now than before, she said, and of course a vaccine in the works.

The Californian talked to several local nurses to get their reflections on this intense period in their careers.

‘WHAT I’M HERE FOR’

Exactly one year ago, Amanda Swanson, a charge nurse in the ICU at Adventist Health Bakersfield, was at FEMA headquarters for an emergency preparedness training. At a hospital facility, actors staged a mock chemical weapons attack and her training group was taught how to respond.

Six months later she found herself in the middle of the biggest medical crisis in her nearly two decades as a nurse, employing some of what she learned there.

Swanson said she worked through the H1N1 and swine flu epidemics and the Bakersfield hospital was busy but nothing like the number of critically ill COVID-19 patients she and her team cared for this time around.

It was stressful, she said, caring for patients who were so sick and the additional task of having to support the patients' families by phone. It was also hard to watch patients who entered the hospital alert and able to walk and breathe normally slowly decline to the point where they went on a ventilator and often stayed on it for weeks.

"COVID is such a slow recovery process. It’s like watching a pot that never boils," Swanson said. "You go in every day and wonder if you’re going to see any change."

Swanson also remembers how the disease affected entire families.

On the phone with a patient's loved ones, she would be told that another family member was being treated for COVID-19 on a separate floor or in a different hospital, or she would hear family members coughing on the phone.

Swanson said she had wanted to be a nurse since she was a young child and working through the COVID-19 crisis, as tough as it was, felt like an affirmation that she had chosen the right profession.

"Just to have all this come up after (the FEMA training), it was like this is what I am here for," she said. "This is what we’re supposed to be doing."

‘WE NEEDED EVERY OUNCE OF HELP’

Melissa Woods works as a charge nurse on the medical surgical floor at Adventist Health Bakersfield. Her unit received the hospital's first COVID-19 patient.

She remembers the lead-up to COVID-19 reminded her of the preparations the hospital took for Ebola.

Unlike Ebola, however, Woods said she expected COVID-19 to happen in Bakersfield.

"We just never anticipated it would go on for so long," she said.

She, too, remarked on how different it was not to have patients' family members by their sides. But she also recalled the creative, nonmedical ways nurses found to help their patients, for example, by finding a window that would allow a family member to wave at their hospitalized loved one.

The teamwork and cohesion among the nursing staff and other hospital workers was strong and even people not working in her unit would stop to help out.

"Everyone pulled together because they knew we needed every ounce of help to take care of our patients," she said. "I don’t think we’ll ever see anything like this again. I hope not. It was certainly an experience I’ll never forget."

She also said the support of the hospital administration and the community buoyed her and her co-workers through a hectic time.

"I think there was never a better time to be a nurse," she said. "We got so many donations and they would deliver food and cards and we felt really supported."

‘RIGHT WHERE I’M SUPPOSED TO BE’

It was Kellianne O'Neill's birthday in March on the day the first COVID-19 patient came to the ICU.

"I remember how scared she was and we were trying to get the family on the phone and explain everything," said O'Neill, 34, a charge nurse at Mercy Downtown and Southwest hospitals.

The doctors and nurses were trying to convince the woman to go on a ventilator, which she did. The patient eventually recovered and was discharged.

Going forward, O'Neill stopped wearing her typical business casual attire to work and has been in scrubs ever since.

"I wanted to make sure the staff felt supported, that I was there at the bedside," O'Neill said. "I would never ask my staff to do anything I wouldn’t do."

With the county advancing through the state's reopening tiers, O'Neill said, "it’s a little stressful worrying about if that’s going to impact things."

"I just hope the community remains vigilant ... doing all the things we’ve been taught to do to keep the incidence of COVID down. Just remember that because we’re opening back up, COVID hasn’t gone away," she said.

Overall the experience, the former Army Reserve nurse said, has helped her to become a stronger leader.

"It’s also helped to remind me why I became an ICU nurse in the first place," O'Neill said. "Which is always nice to know I’m right where I’m supposed to be."

‘I WANT PEOPLE TO KNOW WHAT HAPPENED’

As an ICU nurse for five years, Leviyeva has had difficult days. But one that stands out among them is when she laid a cellphone down next to a dying woman so her family could say their goodbyes.

"One grandchild told her, 'I'll always treat women well because you taught me that,'" she said. "Her husband called and he was begging her to come home ... he was saying 'please, please, you’re fine, just come home.'"

When she arrived home from work, her fiancé asked about her day and the floodgates opened.

"I couldn’t even talk I just started crying," she said. "I’m pretty sure a lot of people experienced the same thing."

During another shift, two patients coded and another went into respiratory arrest back to back. She described it as "mayhem."

A native of New York City, Leviyeva recently decided to make a change and became a travel nurse. She now works at the University of Southern California's Keck Medical Center in Los Angeles but still works an occasional shift at Memorial Hospital.

"I don’t think (COVID-19) was really the main reason" for the change, she said. "I just wanted to experience other things."

But she said she suspects that those in her position who experienced the COVID-19 surge likely thought of leaving their jobs at some point.

"At the height of it, when everybody was passing away, I’m sure everyone had thoughts about it," she said. "There’s nothing you can do. You put all your effort into it for 12 hours and they’re passing away."