The only technical problem I've had, I think, is that at one point if you were the first person to sign in to a remote system over Remote Desktop, you'd imbue that session with your locale and keyboard layout. No good when I happened to be the first person to log in.
I haven't even found my QWERTY skills atrophying that much; on a non-split or laptop keyboard I can type QWERTY without looking at 75wpm, without too many slips. On a split keyboard, like the ones I prefer to use, if I have to type QWERTY then I do have to look at my hands as I type.
On library computers and such I'm reduced to hunt and peck. It's really hard to switch between dvorak and querty and type both well. I like dvorak enough that it's worth not being able to type full speed on random computers.
On my phone everything goes well, but on other computers or on my iPad's Zagg keyboard... It's a mess.
I can still type QWERTY if I need to, even though I have barely used it in the past 13 years or so, but it takes me a few minutes to adjust and get up to speed. This happens if I need to use someone else's machine, which doesn't happen a lot. They wonder why I'm suddenly typing like an orangutan. But it goes away after maybe 10 minutes, then I'm up to maybe 70% of my Dvorak speed which is good enough for most short-term purposes. It still feels awkward to type QWERTY, so I try not to do it for more than a couple minutes.
(Interestingly, most of the problem when switching comes from punctuation, the muscle memory for typing punctuation seems to be separate in the brain. I noticed this when I was first learning Dvorak. I'd type 'v' instead of periods all the time, even when I was reasonably fluent with typing letters. Now the same thing happens in reverse, where I'll type 'e' or 'w' instead of periods or commas if I'm typing QWERTY.)
Overall, the fact that I'm using a different keyboard layout isn't something that I think about much. I'd be surprised if I'd even thought about it more than twice in the last six months.
It was a huge boon for my wrists when I switched, as they were starting to hurt but switching gave them a "break" as I learned the new layout, and then the new layout was more comfortable so the wrists stayed comfortable.