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Studies show that first-line nurse managers (F-LNMs) experience high psychological job demands and inadequate managerial guidance. The purpose of this study was to investigate whether F-LNMs have higher stress levels and show more signs of stress-related ill health than registered nurses (RNs).The aim of this study was to examine possible differences in self-rated health between F-LNMs and RNs on various psychosocial factors (e.g. job demand, job control and managerial support).Data were collected at a university hospital in Sweden. Sixty-four F-LNMs and 908 RNs filled in a web-based questionnaire.Both F-LNMs and RNs reported having good health. Approximately 10–15% of the F-LNMs and RNs showed signs of being at risk for stress-related ill health. Statistically significant differences (Mann–Whitney U-test) were found in the distribution between the F-LNMs and the RNs on three indices of job control, job demand and managerial support.Our findings suggest that F-LNMs were able to cope with high-demand job situations because of relatively high control over work.The implication for nursing management shows the needs for a work environment for both F-LNMs and RNs that includes high job control and good managerial support.