This paper presents an empirical study of the influences of transactional (TA) and transformational (TF) leadership on organizational effectiveness (OE), measured as the degree of goal attainment and the quality of nursing care (NQ). The study subjects were all head‐nurses and assistant head‐nurses at a medium‐sized hospital in Sweden (n=23). The methods used were questionnaires and interviews. The multi‐leadership questionnaire earlier developed by Bass was modified and named the Leadership‐Nursing‐Effectiveness Questionnaire (LNEQ), comprising 84 items using Likert‐type scales. The study showed low mean scores on OE (2.19) and TA (1.05) but high mean scores on NQ (3.17) and TF (3.84). The results suggest that the degree of TA and TF leadership had a low and insignificant connection with OE in this hospital organization. The study did not support the statement that organizational units exposed to a higher degree of TA and TF leadership at the same time show a high degree of OE, as has been shown in studies in other cultural contexts and organizations.