Background: Over the past four decades, many healthcare organizations worldwide have adopted shared nursing governance (SNG) to improve nurse satisfaction, engagement, and patient outcomes. While some SNG models have enhanced autonomy, they have struggled to achieve full independence for the nursing profession as originally envisioned. Scholars now recommend moving from SNG to professional nursing governance (PNG), emphasizing full autonomy, accountability, and self-regulation.
Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was twofold: to evaluate the current state of SNG at a large academic medical center in Southern California, which has grown its SNG model for over 20 years, and to identify strategies that support its evolution toward PNG. 
Methods: A descriptive, cross-sectional study was conducted using the Verran Professional Governance Scale (VPGS), Control over Nursing Practice Scale, Job Satisfaction Scale, and the Structural Professional Governance Self-Assessment Survey. The sample included 1,318 frontline nurses and nursing leaders across 24 inpatient nursing departments. The Human-Centered Leadership in Healthcare framework guided project implementation and evaluation. 
Results: A total of 378 responses met the inclusion criteria, revealing varying degrees of PNG behaviors across units. The highest-rated subscale was collateral relationships, indicating strong peer collaboration and support. The lowest-rated subscale was professional obligation, reflecting limited engagement in health policy, public advocacy, and broader professional activities. 
Conclusion: This project underscores the need for evidence-based strategies to transition from SNG to PNG. Human-centered leadership and validated governance tools can guide nurses toward greater professional autonomy and self-regulation within the healthcare system.