Nursing is largely an invisible profession because of the stereotypical view that nursing is feminine. The derived theory of Defrino (2009) views nursing work as having been structured as a job held by women. While there are increasing numbers of men in nursing, it has been shaped and continues to exist according to a female gender perspective of relational practices.

Even though the number of men in nursing continues to rise, there are still far fewer men in the profession. Moreover, nursing work which involves taking care of the sick, providing basic needs like feeding and bathing, and giving health education are said to be characteristic to the role of women as mothers. Despite research works to yield desired outcomes in the clinical setting, there are still few studies exploring male nurses' capability of rendering the same nursing care as compared to female nurses. This is what makes masculinity in nursing a critical site for exploration. In light of this, a concept analysis is necessary to clarify the defining attributes, antecedents, and consequences of the concept ( Walker and Avant, 2005). Additionally, a concept analysis will contribute to the delineation of masculinity in terms of its contemporary conceptualizations.

Based on Merriam-Webster's Online Dictionary (2015), masculinity is the quality, state, or degree of being masculine which is comprised with the set of qualities considered appropriate for or characteristic of men. Contrary to the Webster's definition, Connell and Connell (2005) described masculinity as not equivalent to men; it concerns the characteristics of a person in a gender order. Masculinity cannot be defined completely as the opposite of feminism. What makes men masculine cannot be based completely on biological sex, as the definition masculinity is clearly embedded in societal norms and values. In addition, Kimmel and Bridges (2011) explicate that masculinity stresses gender, unlike male, which stresses biological sex. On the same note, Wingham (2012), Fonceca (2010), and Cernovich (2012) identified traits that are commonly associated with masculinity which are: independent, non-emotional, tough-skinned, competitive, strong, active and self-confident, integrity, stability, passion, discipline, responsible, honest, leadership, and logical thinking.

Based from Kimmel and Holler (2000), masculinity traits refer to the social roles, behaviors, and meanings in any given society at any time. Furthermore, Kimmel and Bridges (2011) define masculinity traits as behaviors, social roles, and relations of people within a given society as well as the meanings attributed to them.

Setting sex aside in the concept of nursing care, nurses work in order to attain outcomes not only for their patients and the organization, but for their professional growth as a whole. Hull (1982) posits that the shared view of nursing from its early history has been based on an analogy between the nurse and mother. Nightingale and other originators of nursing saw nursing as a natural vocation for women second only to motherhood. Thus, the view arose that nursing as a vocation was more suited to women than men, since women naturally perform such actions as nurturing, caring, and education.

The popular assumption that nursing is women's work accompanied by the taken-as-given that women use intimate touch to demonstrate physical and emotional care has constructed touch as a natural part of a woman's caring repertoire. This is accompanied by a discourse in which men's use of touch is perceived as suspect (Harding, 2009). Cude and Winfrey (2007) supplement that in Florence Nightingale's time, men were considered to lack the capacity to provide mothering and caring because “their horny hands were detrimental to caring,” so they were excluded from nursing.

Gender discrimination can be felt in the health care profession and it is mostly tied to specific “areas” in the field, which are often linked to female characteristics. Although men choose to become nurses for the same reasons as women do, often they are represented by media as “male nurses” and women as nurses (Meadus, 2000). I am fully mindful that pioneers in the nursing profession, including theorists and practitioners are all women. In my standpoint, the role of caring for the sick does not have anything to do with sex. It is the strong bond of cultural and gender bias in our society that fosters nurturing traits in women and not in men.

Antecedents are events that are required to take place prior to a valid occurrence of the concept ( Walker, 1995). According to Ferrante (2007, p.269), the mixture of sociallydefined and biological factors distinct from the definition of the male biological sex leads to the concept of masculinity. In this view, presence of situations that require male nurses to render nursing care, which is not different to the care rendered by female nurses is necessary. These situations may vary from emergency to close care nursing.

Defining attributes are a list of the features of a concept that appear over and over again when reviewing the literature ( Walker and Avant, 1999). Masculinity has the determining characteristic of set of qualities considered appropriate for or characteristic of men. It is the possession of courage, independence, competitiveness, especially when it comes to improvement, assertiveness, leadership, flexibility, alertness, and logical thinking.

According to Kimmel and Bridges (2011), masculinity stresses gender and deals with the diversity of identities, behaviors, and meanings that occupy the label masculine and does not assume that they are universal. Moreover, Clay (2012) presents that the possession of traditional male traits and the inclusion of full range of human emotions is masculinity. Therefore, masculinity also involves care, gentleness, considerateness, compassion, and empathy.

Consequences are events that take place consequent to the concept's occurrence ( Walker, 1995). The consequence of exploring masculinity in nursing relates to both positive and negative aspects. As a positive experience, the use of masculinity traits supports and not compromise the delivery of nursing care to patients. It can also increase patient satisfaction from the care rendered. As for the negative consequence, the use of masculinity traits lessens the quality of nursing care given to patients. This results in decreased satisfaction and low self-esteem of male nurses.

A model case is one in which all of the defining attributes are present ( Walker, 1995). The goal of John since he was still in high school is to become a nurse in the future. In spite of all the discouragements he received from his classmates in high school that nursing is a job for women, he still enrolled Bachelor of Science in Nursing in college. John was the only male in his clinical grouping so whenever the group encountered a heavy task in the hospital that would require power and strength, they always call him to do it. The main problem he came across in his clinical duty was a rude patient in the Gynecology ward who rejected him and opted to have a female student nurse. The patient told to John that male nurses cannot deliver quality nursing care because they possess masculine traits that are not fit to nursing. Instead of asking his clinical instructor to be assigned to another patient, John was assertive enough to tell the patient that nurses regardless of sex are still nurses and they deliver the same quality of nursing care. The patient even shouted at John to move away, but he remained calm, showed confidence with his knowledge and skills and proceeded with his nursing interventions. John held his patients and exhibited compassion and empathy which are innate characteristics of a nurse. During the shift, John was seen having a meaningful socialization with the patient and that showed John's love to the calling of his profession. John was gentle in rendering quality nursing care to his patient from injection of medications, feeding via NGT, therapeutic communication, and health teachings.

John continued to become a model student nurse in his school and when he graduated, he was awarded the highest clinical practice merit as the “Outstanding Nurse Intern” of his batch. As a novice nurse in the emergency room, he experienced a lot of stereotyping and refusal from patients because he is a male nurse. He then took the challenge and withstood fear and difficulties to prove that he is an exceptional nurse. He demonstrated courage and alertness in all emergency cases he handled. As a result, he was regarded as the best emergency room nurse not only by the physicians, but also by his nursing colleagues. Because of his competitiveness among other emergency room nurses to improve the efficiency and effectiveness of nursing care, he got promoted as a head nurse by the hospital chief after 3 years of hard work. John became the youngest head nurse in the hospital where he worked. For his quest for self-directed learning and willingness to try new things, he finished his master's degree and eventually, his doctorate degree in nursing. He was flexible enough and was able to adapt in the academe and clinical setting using his time management skills. He now works as the chief nurse in a government hospital and he is highly regarded as the best chief nurse not only because of his nursing skills and academic achievements, but also his abstract thought and reasoning when it comes to matters related to the hospital. In addition, through his logical thinking skills, all nursing problems are carefully and systematically resolved. He always encourages his staff nurses, head nurses and nurse supervisors regardless of sex to work hand in hand to render the best care to patients.

Jenny works in a government hospital and is known as a strict and perfectionist head nurse. Every time she is on duty, she always reminds her staff nurses with a loud voice to organize every intervention and complete the hand washing checklist. One thing that is unique to her characteristics is that she believes that female nurses are more skillful, caring and compassionate than male nurses. She considers the possession of feminine traits, such as being empathetic, vulnerable, intuitive, thoughtfulness, patience, and radiance to be the only attributes appropriate in the delivery of nursing care. According to Jenny, masculine traits should not be integrated in the nursing profession. As a result, she is despised not only by male nurses, but also by female nurses because of her sexist belief in the practice of nursing.

Jose works as a receptionist in a 5-star hotel where all of his colleagues are females. When he was still a newly hired employee, he experienced stereotyping not only by his colleagues, but also by clients because they are not accustomed to a male-receptionist in a prestigious hotel. Some hotel clients even told him that only females are allowed in this field because males have the tendency to be hostile and hard when dealing with people. At first, he was depressed and belittled, but in the long run, bad experiences motivated him to strive harder and prove that he can be an asset.

His hardwork paid off because he was constantly hailed as the best employee in his area of assignment. He became popular not only among the employees, but also by regular clients who kept on praising him for his commendable performance. Jose now works as a manager in the same hotel and is still as humble as he was before. In spite of his success, he did not have any emblems of arrogance in him. He always believed that sex is not a factor in the performance of a job in any chosen field; it is hard work and perseverance.

Nurses are expected to perform heavy jobs or interventions, such as transporting patients, assisting during operations, carrying heavy operating room instruments, and keeping agitated, and violent patients calm. Especially for nurses who work in settings that revolve around patients who require immediate care, assistance in walking, and has difficulty in mobilizing, the repetitive strain these situations provide put physically, mentally, and psychological burden to the nurses. Thus it is required that a nurse must possess masculinity traits.

For male nurses, diverse masculine ideas play a significant role in their psychological well-being. In particular, a lot of them experience negative consequences when these ideals are threatened by feelings of insecurity, inadequacy, and inferiority. These include psychological distress, higher degree of shame, and low perception of self and ability ( Edwards, 2015). Oftentimes, these feelings arise because of stereotyping. Stereotyping can affect the manner in which male nurse interacts with their fellow colleagues, patients, clients, and the way they deliver their care.

Nurses in clinical practice, education and management need to listen to the voices of male nurses and their experiences of being a man in nursing. They are telling us that the field needs to address barriers related to gender based stereotyping. Furthermore, to break the gendered glass ceiling that continues to exist for men in the profession, we must pay attention to normalizing nursing as a career for men and to ensuring that men are treated first and foremost as nurses, rather than as male nurses. Most importantly, the interpersonal caring aspect of nursing should be highlighted as something that belongs to all nurses—as nursing does not belong to one gender, neither does caring ( Rajacich et al., 2013). Thus, the possession of masculinity traits does not make male nurses as different when it comes to the delivery of nursing care; instead, it helps them to deliver the care in a manner that is best for patients.

In summation, the concept of masculinity in nursing as presented in this paper is related to presence of masculinity traits of male nurses. Moreover, it is reflected in the concept analysis that the possession of masculinity traits does not hinder the delivery of nursing care to patients. In addition, what is unique in the model case is that the traits are expressed in situations, involving different ways in providing nursing care without preservation. Given the societal view of nursing as “women's work” because of its association with caring and empathic tasks, we should treat these attributes as human attributes rather than as stereotypically feminine. In another facet, we can as well state that there is no such thing as sex stereotyping in nursing because the profession entails both sexes.