Unfortunately I believe that most patients will be colonized with microorganisms (some resistant) by the time they leave the hospital (if they aren't already...they are now in the soil in my area...VRE and MRSA). I think most nurses are potentially colonized. The mutants are winning. All we can do is our best, but patients will still unfortunately develop nosocomial infections despite our best efforts. We can't control all links in the chain at the nursing level.
I'm really disillusioned by the 'handwashing saves the day' lines, because the way I see it, we don't operate in sterile conditions, and I don't see all working and living surfaces in our areas being disinfected enough. Would anything be enough today? I wonder sometimes. We can only do so much. Constant gloving and disinfecting of the hands takes it toll...my hands can only take so much.
But we continue to be made to feel guilty because 'we can't wash our hands enough'. I think we're just an easy target.
The problem goes much deeper, IMHO. The public demands abx, the mutants are getting stronger, our patient's are complex and compromised, and facilities (and staff) are not sterile. Just some participants in the problem.