On her first day of nursing clinicals, Valerie Nevaeh Gale put some of her newly-learned skills to practice at Methodist Metropolitan Hospital: inserting intravenous catheters and preparing patients going in and out of cardiovascular surgeries.
“I even went into the operating room,” Gale said as her day was coming to an end. “That was really cool because I was literally up close and personal watching. Once they started doing the incision and stuff I took a step back, but then they had it broadcasted and I could ask as many questions (as I wanted).”
Gale is part of San Antonio College’s first cohorts of students earning an associates and bachelor’s degree in nursing concurrently — a field in which college and healthcare officials agree there is a continuously growing demand. This is one way the college is trying to encourage students to complete degrees while saving them time and money by offering related courses at the same time.
This fall was the start of Gale’s second semester. Her first clinical rotation was at Methodist Metropolitan’s cardiovascular catheterization lab where doctors perform thousands of heart procedures and surgeries per year.
She is part of a cohort of 270 students, most of them already registered nurses. The program started with 22 students in 2021 and has now graduated 91 nurses with bachelor’s degrees.
“From the very entrance now, we’re setting our students up to be able to achieve the BSN. It’s all in alignment,” SAC President Francisco Solis said. “They don’t have to worry that any of their previous credits don’t go towards the BSN program. Even the prerequisites work.”
SAC’s School of Nursing and Health Professions is also on the verge of doubling in size with the construction of a new building to be located in the medical center as part of the $987 million bond approved by voters in May.
Nursing and Allied Health Complex building at San Antonio College on Aug. 6, 2025 Credit: Vincent Reyna for the San Antonio Report
This was part of the Alamo Colleges District’s planned expansion to offer bachelors degrees in specific areas of workforce demand.
In the case of nursing, students have the opportunity to choose between three fully online tracks, a hybrid option and the concurrent program for those who are not yet registered nurses with an associate’s degree, like Gale.
“So in two years they finish with their associate degree, then they test for licensure, and then they finish their last course of their bachelor degree and they’ll graduate with their (BSN),” explained Dr. Eve Rodriguez, executive director of the Registered Nurse to Baccalaureate Program.
Crissy Womble, Methodist Healthcare associate vice president of academic partnerships, oversees partnerships with colleges for clinical opportunities across its 11 hospitals. She said population growth across the San Antonio region means more hospitals and clinics — but also a need for more staff to provide the care.
The demand for qualified nurses is so great that even if all current students were to graduate there would still be open positions, she said. The hospital system has worked to increase clinical spots to accommodate for the growth of programs like SAC’s and the region’s demand.
“This year we’ll be close to 3,000 graduates locally in the city for nurses. And that won’t fill all of the need,” Womble said. “ So if all 3,000 came to us, we’d be good, but that’s not going to happen … last year we hired about a thousand (new graduate) nurses, and will be hiring more than that this year.”
An issue of cost
Gale knew she wanted to pursue a career in healthcare at an early age. She was a sick kid, she said, her body doesn’t produce enough hemoglobin and she had to get blood transfusions often.
It was there, through the nurses who took care of her as a child, that she learned to love the profession.
“I started asking questions,” Gale recalls. “Like, ‘Can I put in my port?’ ‘Can I do this?’ ‘Can I push the buttons?’ … When you are in the hospital for a while you start to make friends.”
San Antonio College nursing student Valerie Nevaeh Gale displays a collapsable medical clipboard with quick-facts that she carries in her uniform on her first day of clinical rotations at Methodist Metropolitan Hospital on Tuesday, Sept. 9, 2025. Credit: Amber Esparza / San Antonio Report
Her military family moved a lot, and Gale started her nursing degree at the University of Virgin Islands in St. Thomas. Shortly after, there was an accreditation issue with her program, Gale said, and she had to start looking for other programs.
Cost was a big priority of Gale’s as she didn’t want to put the burden of paying for nursing school on her mother who was raising her and her two siblings as a single mom.
She then turned to San Antonio, where her mother grew up and where Gale spent part of her summers visiting her grandparents.
She applied to the University of Incarnate Word, but she said it was not at the top of her list due to the cost of a private school being higher than what she could afford. Then she applied at the University of Texas at San Antonio, but she was told at the time she had to take her core courses at UTSA before applying to the then separate institution UT Health San Antonio.
Tuition in the 16-month accelerated bachelor’s program at UIW is expected to cost between $73,000 and $76,000. At UT San Antonio, a similar program is slated to cost between $53,000 and $65,000. While those figures don’t include financial aid, they also don’t account for the cost of living for a student moving to the city, like Gale.
At SAC the bachelor track is offered for about $10,740. This year, Gale was expecting to pay close to $4,000 in tuition, but she ended up paying nothing after faculty encouraged her to apply for as many grants and scholarships as possible.
That’s money she can now put towards something else, a true blessing, she said.
The opportunity for Gale to earn a bachelor’s along with her associate’s degree was one she didn’t know was even possible. After transferring her credits and catching up on the prerequisites that she couldn’t transfer from her previous college, Gale was invited to apply for the concurrent program.
“That was the first time I ever heard that there were so many different tracks,” Gale said. “I never applied for the concurrent (program). It was something that they brought to me … I really appreciate that because it made me realize, ‘Dang! Maybe I’m not just a number.”
Taking an extra step
Yolada Ruiz, a registered nurse with a tenure at Methodist Hospitals of about 12 years, was one of the four nurses that Gale had an opportunity to shadow on her first day of clinicals this semester.
Ruiz herself graduated from SAC with an associate’s degree about 12 years ago, she said, then she eventually earned her BSN through Our Lady of the Lake and the University of Saint Mary in Kansas. Right now she is hoping to continue onto a doctorate degree in nursing.
San Antonio College nursing student Valerie Nevaeh Gale, left, and her charge nurse Yolanda Ruiz chat about Gale’s first day of clinicals at Methodist Metropolitan Hospital on Tuesday, Sept. 9, 2025. Credit: Amber Esparza / San Antonio Report
“I’ve always enjoyed teaching,” Ruiz said. “I’ve always taken my experience and tried to incorporate it into the experience of nursing students that come in because, you know, when you’ve been there, you know what to expect and what nursing students struggle with.”
Womble said every nurse that works at Methodist takes on a similar teaching role. This allows them to continue training candidates that could stay and fill positions at the hospital they trained in, or move to another one of their hospitals and know they’ve received training from their own staff.
Licensure test passing rates will help the hospital system determine which program to prioritize for clinical rotations, she said. Over the last few years, Methodist has increased the number of clinical groups they’ve been able to welcome for rotations, from 51 student groups in 2024 to 67 in 2025.
Ideally, many of these graduates will remain in their hospital district, or at least the region.
“The goal is that we are preparing them well, we want them to stay local in San Antonio,” Womble said. “We would love them to be at Methodist, but we will encourage them to just be here. We want to care for our community.”
Through programs like SAC’s hospital systems also get to see their own nurses move up the ladder. According to Methodist survey data, about 95% of the nurses who earned a bachelor’s degree reported a promotion and a wage increase, and 81% said they plan to apply to another graduate program.
The programs are always being examined to meet rigor expectations and provide the needed hands-on training for students to get licensed and hit the ground running, Rodriguez said, but she believes they’ve developed a good blueprint to expand the program to the Medical Center.
“I feel confident that our program here could be streamlined anywhere,” Rodriguez said. “It’s going to make it even more accessible to everyone because it’s going to be central and it’s going to have everything needed.”
This December, the college is slated to graduate their first concurrent cohort of about 7 students. This cohort started with about 30 students, but 23 were not successful in completing their associates.
“It is very challenging for students to adapt to the changes and time needed for study,” Rodriguez said. “To avoid them failing again, they are removed from the (bachelors) to focus only on the (associates).”
Gale is expected to graduate in 2026, and hopes to land in a fast-paced emergency room, perhaps in San Antonio or Texas before traveling out of state. For now, she found work at Methodist Hospital Northeast as a nurse extern on top of her clinical rotations to get through college with the most experience possible.
For Gale, a self-described planner and an overachiever, it is the rigor of the program that keeps her motivated.
“For me school always came easy,” Gale said. “In the nursing program, it’s more like, ‘Hey, we’re going to teach you to take the extra step’ … I’m really working for my education in the best way possible. I’ve created new habits that I’ve never had before, that I only know will help me once I get into the field.”