Childcare considerations for Advanced Practice Providers

By Guest Blogger, Corrie Morris, MSN, FNP-C

When I found out I was pregnant with my first child, I had been working as an NP for several years. Despite a great job, wonderful coworkers, and having some professional experience under my belt, navigating life as a working parent was all new to me.  As soon as we began to share our exciting news, my friends and coworkers with children immediately inquired about what arrangements I had made for childcare.  I didn’t even have a crib or a name picked out, much less a plan for who would take care of the baby while my husband and I worked.  Finding the right childcare arrangements can be difficult (and expensive!). Below are some considerations for your search to help guide your search.

Nannies- Finding a great nanny is like finding the proverbial pot of gold at the end of the rainbow! If you have one, DO NOT let them go!  When my oldest daughter was a baby, we had a fabulous nanny who came to our home to watch her while we worked. She was a retired teacher who kept our baby on the schedule we set, played attentively with her during the day. As part of her job she also helped make baby food and did our daughter’s laundry while she napped. As a first-time mom, I loved that our daughter could nap in her own crib during the day and have someone’s undivided attention while we worked.


  • Your child is cared for in the safety and security your own home provides.
  • One to one attention (or at least a very small ratio if you choose to nanny share)
  • No packing up in the morning to rush out the door or picking up from a facility after work.
  • Help with childcare related tasks such as baby’s laundry, preparing bottles, etc.

Things to Consider:

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  • Always personally check references! Talk with other families this person has worked for or to prior employers.
  • You will likely need to find back up childcare when the nanny is sick or cannot be at work. This can be difficult in last minute situations.
  • Private sitters can be expensive, there are also usually taxes that will need to be withheld if the nanny makes over a few thousand dollars per year.
  • It takes effort to maintain a good working relationship with your nanny. Reevaluating salary, daily duties and schedule is a constant. Clear communication is a must. It can be frustrating if your nanny moves on and can be time consuming to search for and train someone new.

Daycares- Daycare is certainly the most reliable form of childcare. I have many friends who started their children with a family member or sitter but after the caregiver was sick, late, or had other issues, consistency quickly rose as their top priority.  Daycare offers a great opportunity for kids to socialize and depending on the facility you choose, can offer many educational, cultural, musical, artistic, and language enrichment programs.


  • Staff are trained and licensed and there is always a sub if an individual need to be out.
  • Daycare offers social interaction and a more structured environment usually with a set curriculum
  • Many childcare facilities that are associated with large companies (ie. many hospital systems) offer lower rates and extended hours knowing that many employees work shifts beyond regular business hours.
  • Many daycares offer childcare from infancy until children start kindergarten and some even offer after school programs for older children.

Things to Consider

  • While the student to teacher ratio varies from state to state and facility to facility, it is important to feel comfortable with how many children will be supervised by one teacher.
  • Always talk to other parents of children that attend the school. What has their experience been? How have concerns been addressed?
  • How does the facility line up with your family values and parenting style?
  • No matter what lengths are taken to keep facilities clean and keep kids healthy, it is likely your child will be exposed to more illnesses. If your child has other health issues such as chronic asthma, severe allergies or other medical problems, you may want to discuss childcare options with your pediatrician.

Au Pairs– Unless you live in a major metropolitan city where Au Pair programs are common you may not even be familiar with this option. It wasn’t until after my 3rd child while living in Houston, Tx. that I was even made aware of Au Pair Programs.  An Au Pair (French for “on par”) is a young adult (ages 18-26) from another country with documented childcare experience and training who apply for a childcare position with an American family for a period of 1-2 years.  These young women and men live with their host family and provide childcare while parents work and cultural enrichment for the family.


  • Au Pairs can work up to 45 flexible hours per week.  When working with an agency to find an Au Pair that would be a good fit for your family you can request someone who is comfortable working nights/ weekends or other odd hours. This might be a great fit for families that do shift work, have clinic or hospital call responsibilities or work nights/ weekends.
  • Cultural and language enrichment for your children
  • Despite Au Pair Agency fees and the Au Pair’s weekly stipend this can be a cost-effective childcare solution especially for families that have multiple children.

Things to consider:

  • Au Pair visas are usually only valid for 1 or 2 years and in today’s political climate these visas have become somewhat harder to obtain.
  • There will be another adult living in your home so consider the space your home provides and privacy you desire.

Family: To have grandparent, sibling or other family member care for your child will certainly create a special bond. It is always reassuring in the midst of a busy workday to know that your little ones are under the loving watch of a grandparent or other relative. The support, flexibility and cost savings associated with family caregivers is undeniable. Since your child likely knows this person well already the difficult transition to a new childcare provider will be mitigated.


  • Cost savings $$$!!!
  • Your child will be cared for by a loving family member who likely shares your values.


  • Sometimes family members can become overwhelmed as full-time caregivers. Before the baby is born grandma keeping the baby sounded like a great idea but consider at least a few trial days to ensure it will be sustainable.
  • Conversations about details are important and can be sensitive. Will the family member come to your home or will you drop your child off at theirs? Will there be any compensation? Are you on the same page as far as schedule, food, discipline, and screen time? All of these should be addressed with any caregiver however to generational differences or family dynamics these discussions can be difficult.

Like many things in our work as advanced practice providers and parents, a family’s childcare will likely change over time. While there are certainly special situations, I know very few children who have been with the same caregiver from birth until they went to school full time.  As an expecting parent, I hoped that would be my situation, but it has not been.  Since having children, I have worked full time, part time and stayed home. Every year, if not every few months, my husband and I have to revisit our family’s childcare needs.  We weigh our own job hours and requirements, growth and needs of our children, and finances. We have faced challenging situations we have had to work through to keep our children well cared for while we work.  We have also had wonderful nannies, teachers and now an Au Pair in our lives and our children have benefited from all of them.  What has been the best childcare solution for your family? What are resources you have utilized as a working parent?


Corrie Morris has been a nurse practitioner for over ten years. She has experience in internal medicine and electrophysiology, and is a frequent speaker for our ThriveAP curriculum. She has a passion for patient care, advocacy, and education especially regarding patients with pacemakers, defibrillators, and other implanted cardiac devices. 



Resources:  and Homepay by Breedlove – a great resource for those seeking a nanny or sitter. Can also be used to pay and file taxes on household employees / NannyChex- another great resources for filing taxes on household employees. / – one of the top Au Pair agencies in the country with information about this underutilized option. / another fabulous Au Par agency / a great resource to learn about daycares in your area with information about their licensing and accreditation / Don’t forget get to check with your Human Resources department about Employer Assisted Dependent Care Plans that often allow employees to set aside pre-Tax dollars to pay for childcare . Employers also may have an onsite daycare or have relationships with local child care providers that offer discounts.

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