Healthcare organizations increasingly implement shared governance (SG) models to empower frontline nurses in decisions related to policies, staffing, and resources. Unit Practice Council (UPCs), a core SG component, aim to foster professional autonomy, communication with leadership, and improved patient outcomes. However, the Medical-Surgical/Telemetry (MST) UPC at a community hospital experienced low engagement and high attrition, resulting in operational and financial setbacks. This program evaluation examined the MST UPCs by identifying strengths and weaknesses, assessing nurse perceptions of its functionality, and measuring satisfaction with council participation. Twenty-three nurses, including UPC members and non-members, completed a survey utilizing a five-point scale and open-ended responses. Results revealed key barriers: 75% of involved nurses reported disengaged leadership, and 87.5% cited insufficient time to participate in council work—despite recognizing its positive impact on patient care. Among non-participating nurses, 80% were unaware of what a UPC is, indicating a need for targeted education. Additionally, 80% expressed dissatisfaction with unit quality. Sixty percent felt leadership failed to model effective practices, and 53.3% reported feeling they had no voice in efforts to improve quality. Although the UPC had a defined structure and potential benefits, its impact was hindered by limited leadership support, time constraints, and low awareness. Many nurses struggled to balance clinical responsibilities with UPC duties, and inconsistent leadership support contributed to disengagement and attrition. These challenges limited the UPC’s ability to enhance job satisfaction and patient care outcomes. To improve effectiveness, the council would benefit from increased and strengthened leadership involvement, enhanced communication, and designated time for UPC activities. Educating staff on the UPC’s purpose and providing structured leadership support could boost engagement. By addressing these barriers, the UPC can evolve into a robust SG model, one that fosters nurse engagement, team collaboration, and improved patient outcomes.