Emergency medicine requires flexibility as we work irregular shifts, nights, weekends, and holidays. Unlike the general populace, we face the unique challenge of seeking childcare options that can adapt to unpredictable and often nontraditional work hours, requiring creative solutions or adjustments to the typical childcare options. Here are some to consider.

Daycare Centers

“[My daycare] does drop-in day care. You buy five days at a time and then let them know the week before you want to use one. Only weekdays though.”

—Dr. Kaps

Day cares and programs are great options if you have partners who work more “regular” hours. Many day cares have drop-off as early as 7 a.m. and pickup as late as 6 to 9 p.m. As your child gets older, they may start attending educational programs with shorter hours, but these facilities often offer extended or flexible care options. Day care can be a more affordable option than nannies and babysitters and has the added benefit of early socialization.

Nannies and Babysitters

“I posted on every social media platform, and almost everyone we talked to said they weren’t interested in our erratic schedule. We found one woman who quit after just one summer, and the search had to start all over again.”

—Dr. Grossman

Hiring an in-home caregiver (e.g., nannies, nanny shares) can be especially challenging, as caregivers often expect regular daytime hours. Be up front in searching for caregivers who are willing to adjust their schedules to meet your needs. When negotiating pay structures with in-home caregivers, you may need to increase compensation for added flexibility. A mutually agreed-upon contract that is finalized before the start date will help set expectations and get everyone on the same page.

Potential options:

• Hourly Rate with Shift Differentials: Offer an hourly rate, with higher pay during evenings, nights, weekends, and holidays.
• Guaranteed Minimum Hours: Provide guaranteed payment for a minimum number of hours per week or month, regardless of the actual hours worked.
• Standby Pay: Offer standby pay for times when the caregiver is required to be available but not actively caring for the child, such as when you’re on call.
• Overtime Pay: Clearly outline overtime policies and rates for hours worked beyond a certain threshold in a day or week to fairly compensate caregivers for extended shifts or last-minute schedule changes.

Night Nanny/Night Nurse/Night Doula

“I had a rough pregnancy and worked until the day I went into labor. I also experienced postpartum complications. Having a ‘baby nurse’ or ‘night nurse’ was crucial for me during that first month because it allowed me to get the extra sleep I needed to recover and be there for my baby. It also was helpful, as a first-time parent, to learn from an experienced professional how to take care of a newborn. It definitely reduced my anxiety significantly.”

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