Genmedmom here.
Childcare is such a huge issue for working parents. It can be so expensive, and it is so important. With me in outpatient primary care and my husband traveling for his work pretty frequently, we needed to figure it out.
Thankfully, we have my mom who lives close by and provides the bulk of childcare for our little ones. We have also used daycare, as well as nanny services, both to give her a break and to provide socialization for our kids.
Family help is the best, but it can't always work, for many reasons. Daycare has the advantage of providing key socialization, as well as building relationships with other working parents, a bonus that I didn't realize would be until it was. However, if we didn't have my mom to pick up our kids at the end of the day, we'd be pretty miserable. It probably wouldn't work at all.
I found nannies to be the most difficult. It was almost a part-time job to find a decent nanny, even with Care.com. And, they weren't always decent. Plus, that option can be very expensive, prohibitively so. Upwards of twenty dollars an hour in the Boston area, for a nanny with experience.
Other docs have written about au pairs, and that options sounds wonderful, but one has to have a place for the person to sleep, and we just never had that. It's a small house, barely enough room for us and the two kids. Au pair, sadly, was never a possibility for us.
What childcare options have worked best for others?
We're in au pair hiring season for us right now, and I can tell you that is also stressful. But thank you for this post. We elected not to pursue the most expensive cities when I was applying to residency because we were afraid we couldn't afford it since we don't have family who can help in any way. Thanks for the reassurance that we made the right decision. It totally sucks to have to think about your career in this way, but I guess this is what a lot of people outside of medicine have to do too.
ReplyDeleteAll of the options are so massively expensive here in this area- the au pair one as well, as you have to own a property that has the extra bedroom/ bathroom situation to make it feasible. For primary care docs, that's just not going to be easy. The price difference when you add that extra room is substantial, back in 2009 it would have put us looking in the $500k range, rather than $350-400, which was still pushing it for a new attending and a variably-employed sports broadcaster!And that was before real estate prices went back up in the major metro areas.
DeleteMy hospital has a daycare that is open 6am to 8pm. Longer hours are key!
ReplyDeleteI personally think this is something we should all push for at every hospital. I have brought this up with the women physicians group at my institution as well, and they said they are working on it. So far, we have a new benefit of guaranteed backup care for 7 full days/year. But honestly, good quality daycare from 6 am to 8 pm should be a standard for every hospital that wants to hire physicians with families!
DeleteThat is such a wonderful idea- It would boost productivity, no doubt. My colleagues who have to bolt out of here at 5:30 or 6 pm are stressed, unable to finish work, and then financially punished by the daycare if they are late!! Who does that help?
DeleteI could have written your sentiments exactly. We chose daycare because we weren't too keen on a nanny or au pair. It's stressful to both hire a single person who is responsible for your child, and to have another person so close in your living space. Not for us. A good quality daycare facility provides good socialization with both adults and other children. However, the wrinkle is that as an anesthesiologist, my hours start well before any daycares that I have access to are open. My husband used to watch baby, prep for daycare and take her there in the morning, but sometimes he has to travel and it's a lot to do when trying to start work as well. So we hired an early morning "nanny-taxi" who watches baby for about 2 hours and then takes her to daycare each morning. It's working out well, but the only issue is that if there is something I want to communicate to the daycare about my child, it can be lost a bit in the translation when the nanny communicates it second-hand.
ReplyDeleteOh, the complexity!!!I love Practicebalance's suggestion: Good quality, on-site daycare open from 6-8 pm. Holy moly. That would be so key. Imagine how much more work we could all do!!!
DeleteI really didn't like the idea of being depending on one person for child care. I don't mind having my schedule upended when my kid gets sick. I didn't want to have my schedule upended when someone *else's* kid got sick. Eve started group day-care when she was about eight months old (we'd each been on part-time leave until then and we filled in the gaps with a family friend as sitter). She stayed there for preschool and then after school care through 4th grade.
ReplyDeleteOur biggest headache was middle school. There was no bus, and it was too far for her to walk, and there was no after school care. She went home with a friend most days, and we hired a college student to get her to dance class two days a week and stay late on Mondays (our "date night). Not that different from the "nanny-taxi" PracticeBalance describes. We had three different students over five years and it was great.
Summers were also a problem and we ended up paying for weekly day camps plus the college kid to drive her there and back, because they were all 9 AM to 1 PM. Grrr.
Hmm. We will likely run into the same issues given the geography of our town and the middle school. I like the idea of the nanny-taxi but would also be so nervous. It's one thing to hire someone to watch your kid, another to have them driving around with them. But it is what it is and we'll probably be doing it as well, unless my poor mom is still willing and able.
DeleteWe've done it all at different points and with different needs: family care, daycare, live-out nanny, live-in nanny, au pair. So far we have loved the au pair route for the last several years. We do have the room, although have given up our guest room in exchange. The flexibility, driving to practices, being part of the family all have worked really well for us. The big negatives are the 1-2 year continuity maximum which can be tough, especially since the ramp up period and helping get them established with Social Security numbers, the routine, driving, bank accounts, enrolled in a school, etc is rough if too frequent.
ReplyDeleteI wonder why the 1-2 year continuity max?
DeleteThis. We are really struggling right now. Our nanny left us without notice and we are trying daycare, but just had a bad safety scare. We feel very discouraged by the lack of childcare options, and are wondering why it is so hard to find simply just reliable and safe childcare. We are on many daycare waiting lists and are interviewing multiple nannies, but we feel like we have lost trust in this process.
ReplyDeleteIt can be so hard, and I agree, it shouldn't be.
DeleteReading this discussion makes me hope our country develops more policies to support working families. Our struggles are real and ludicrous. We did nanny (not live in), nanny's teenage daughter driving our kids around, and now high school responsible boy doing after school carpool/activities in late elementary and middle school. Still, mornings can be a challenge if I'm on call and daughter has 6am cross country and J is assigned to help with lower school carpool - their stepmom once logged in over 50 miles before 8am when kid's dad was on anesthesia night shift. Not family friendly at all!!
ReplyDeleteMy husband and I are both residents. We have a nanny who comes in as early as 6am to care for our 1.5yr old, and an extra sitter that comes a day or so a week so the nanny is not working too much. My in-laws fly in from across the country to help if one of us has a week of nights etc. Initially we thought about trying to find a daycare that opened at 6, but we just LOVE how our daughter can sleep in while the nanny is here, and then stay up until 8pm so we get hangout time after work. I can't imagine waking her at 5am, getting her out the door for daycare, then putting her to bed immediately upon arriving home again after daycare. Too little hangout time and too much morning stress! As it is, practically half our income goes to childcare, but we're managing to scrape by.
ReplyDeleteDozer- we do the same thing. Husband works in medical related field is out the door before 7.... im a ms4 so my schedule varies. We have a combination of nanny/half day preschool so my kids sleep in, eat good breakfasts, can nap in their own bed, etc. While the kids are at preschool, our nanny is willing to do light cleaning, dishes, folding laundry, etc, which is invaluable. Also, if the kids get sick there is little change in routine. We also have a high school boy who comes at night if we need to work past 6 when the nanny leaves. A nanny is less expensive for us than 2 full time daycare fees so it works best for us.
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