I know what ya mean Burt...while I know the huge hospitals in DFW do these cutting edge types of things, my little ol' ICU doesn't go there much either.
One reason I enjoy my agency shifts is I get some exposure to the latest high tech stuff then.
Prone positioning is ordered by a few select pulmonologists only and we have seen mixed results. And yes..it's a nightmare as we have to do it 'manually' too.