How to Retain a Nanny as a Physician: What We’ve Learned from Real Families Facing Real Schedules
For physician parents navigating the chaos of modern medicine and parenthood
You’re running behind in clinic. The ER just paged again. Your toddler is coming down with something, your spouse is on nights, and your nanny texts:
“Hey, can we talk after you get home? Something’s not working for me.”
Cue internal panic.
Finding a nanny you trust is hard enough. Keeping that nanny when you're working 70-hour weeks, missing bedtime 3 nights a week, and rescheduling date night for the third time this month? That’s a whole new level of parenting acrobatics.
But here’s the good news: it's possible to retain a fantastic nanny even with your unpredictable, demanding schedule. We’ve spent years working with physician families across the U.S.—surgeons, pediatricians, OBs, hospitalists, anesthesiologists—and we've gathered their real-life stories and wisdom (yes, even the hard-won lessons). This guide blends those experiences with what nannies themselves are saying behind the scenes, in forums and blogs, about what keeps them in a job long-term.
This isn’t about perfection. It’s about building a relationship that works—for your family and your nanny.
1. Set Expectations Early—Then Revisit Them Often
One of the most common reasons nannies leave physician families? Misaligned expectations.
Physician families often feel like they’ve communicated the demands of their job upfront, but things shift—and fast. Clinic days stretch. Rotations change. A second baby arrives. And slowly, the original job description starts to resemble a totally different role.
What works:
Build buffer time into your nanny’s schedule. If you think you’ll be home at 6:00, say 6:30. It buys you goodwill and prevents burnout.
Make a written “roles & rhythms” doc. Include start/end times, duties (kids’ laundry? meal prep?), and what’s flexible vs. non-negotiable.
Check in quarterly. It doesn’t have to be formal. One pediatric cardiologist we spoke with does “performance review walks” with her nanny during Sunday stroller outings. “I always start by asking, ‘What’s feeling good? What’s not working?’”
2. Offer Predictability Wherever You Can
It may sound impossible, but predictability doesn’t mean a fixed 9–5—it just means consistency where it counts.
A hospitalist from North Carolina said, “I can’t offer my nanny the same hours each week, but I can give her her schedule at least two weeks in advance—and I never ask her to stay late without notice. That’s made all the difference.”
Real strategies we’ve seen work:
Batch your schedule sharing. One mom on Reddit said she uses a shared Google calendar to post her call shifts and OR days a month out. Her nanny “feels less jerked around” and says it helps her plan her own life.
Use set anchors. Maybe Monday–Wednesday are always full days, and Thursday–Friday flex depending on patient load. That rhythm creates routine, even if exact times vary.
Don’t nickel-and-dime over changing hours. A common frustration among nannies is being docked pay when a doctor parent comes home early unexpectedly. “I block off 45 hours a week and pay that no matter what,” said one OB in Boston. “If I get home early, I just use that time to rest or let the nanny catch up on kid laundry. I want her to feel secure.”
3. Compensate Like You Mean It
Let’s be blunt: physician families often expect a lot. You’re hiring someone to care for your children, manage household logistics, and handle your day-to-day life when you’re called in for an emergency. That kind of support deserves thoughtful, stable compensation.
Tips based on what we’ve seen in forums and real placements:
Guarantee hours. Even if you don’t use every hour every week, guarantee a set minimum. It provides stability for your nanny—and signals professionalism.
Offer benefits. Sick pay, PTO, paid holidays, mileage reimbursement, and even partial healthcare stipends (yes, even $100/month helps) make a difference. One internal medicine doc from Ohio said, “When I added 5 paid sick days, my nanny actually stayed through our awful RSV season instead of burning out like our last one.”
Be competitive in your area. Don’t rely on national averages—what you pay in Cleveland might differ from San Francisco. Ask your agency or browse local listings for reference.
4. Respect the Emotional Labor
This one isn’t talked about enough, especially among high-performing physician families who juggle massive emotional loads of their own.
But here’s the thing: your nanny is absorbing your child’s big feelings all day long. Then when you get home tired, she’s smiling and helping with shoes, while mentally juggling grocery lists, preschool reminders, and your toddler’s nap regression.
What we’ve heard over and over from nannies online:
“I stayed five years with a trauma surgeon’s family because they treated me like part of the team. They sawwhat I was doing—not just the logistics, but the heart work.”
How to show that respect:
Say thank you. Out loud. Frequently.
Don’t undercut. If your nanny sets a boundary (e.g. “We don’t throw food”), back her up.
Give her space. When you’re home, take over. Let her go early when you can.
A family medicine physician in Portland shared this: “We had no idea how much we were depending on our nanny emotionally—until we almost lost her. Now we write a short note each month thanking her for specific things she’s done. It sounds cheesy, but she says it makes her feel seen.”
5. Build a Relationship, Not Just a Transaction
One of the best predictors of nanny retention? The quality of the relationship.
You don’t need to be best friends. In fact, many seasoned nannies prefer some professional boundaries. But they also want to feel that you genuinely care about them—not just the job they do.
What this can look like:
Remember birthdays. One pediatrician in Seattle told us she sets calendar reminders for her nanny’s birthday and work anniversary. “It’s just a Starbucks card and a handwritten note—but she cried the first time we did it.”
Ask how their weekend was. Let them leave early before a vacation. Text to say “Hope your sister’s surgery went well.”
Include them (if they want) in holiday cards or family dinners. For some nannies, this level of inclusion is deeply meaningful.
6. Have a Backup Plan—and Talk About It Early
Physician families know better than most: life is unpredictable. Surgeries run long. Conferences pop up. Your co-parent gets COVID. And your nanny? She might have a dentist appointment, a flat tire, or jury duty.
Having a backup care strategy in place isn’t just practical—it’s respectful.
What works:
Consider enrolling in a backup care service or setting up a relationship with a local babysitting agency.
Talk through your Plan B with your nanny: “If you’re ever out sick, we can call X or Y.” This removes the guilt or pressure they may feel to show up sick or burnt out.
Offer flexibility in return. If your nanny has a family emergency or doctor appointment, let them swap a shift or make up hours later.
A trauma nurse practitioner in Chicago shared: “When our nanny’s dad had surgery, we told her not to worry about hours for that week and sent her a DoorDash gift card. That was three years ago—she’s still with us and says that moment sealed it for her.”
7. Normalize Communication—Even When It’s Awkward
Here’s a scenario every physician parent dreads: Your nanny starts acting distant. She’s not as warm with the kids. She’s watching the clock. Something’s off—but you don’t have time to dig in. You're exhausted. So you wait. And wait. Until one day, she gives her notice.
Don’t let it get there.
Here’s what works instead:
Schedule regular check-ins. One anesthesiologist couple from Minnesota does a 15-minute Friday “coffee chat” to touch base.
Ask directly: “Is anything not working for you lately?” or “Is there anything you’d like to change?”
Be open to feedback—even when it stings. You might learn your child is hitting, your expectations are unclear, or your fridge is empty on Mondays. These are solvable problems if caught early.
As one nanny shared on a parenting forum: “When parents pretend like everything is perfect and don’t give space for feedback, that’s a red flag. I’d rather work for a messy, busy family that wants to do better than one that pretends they don’t need to.”
8. Know When It’s Time to Grow the Role
You found the perfect nanny when your baby was 4 months old. Now they’re 3, potty trained, and enrolled in preschool half the day—and your nanny is wondering, “Now what?”
Long-term retention often depends on role evolution. Great nannies want to feel challenged and useful.
What this might look like:
Adding family assistant duties: organizing playrooms, planning meals, running errands, ordering birthday gifts.
Including educational planning: prepping Montessori-inspired activities or sensory bins.
Offering professional development: paying for a CPR renewal, nanny conference, or early childhood course.
One surgical fellow said, “Our nanny took on so much more once our son was in school. We adjusted her title and pay and now call her our family assistant. She loves the new role—and so do we.”
Final Thoughts
Physician life is a marathon, not a sprint. There will be weeks you’re scraping by, surviving on caffeine and adrenaline. There will be days you barely see your kids. And there will be times when the thought of starting over with childcare feels downright soul-crushing.
But with the right approach—and a whole lot of mutual respect—it is possible to find and keep a nanny who becomes part of your family. Not just because they show up on time and keep your kids safe, but because they’re in it with you. Through the call shifts. Through the chaos. Through the tiny, tender moments you might miss—but they don’t.
Credits & References:
This post was inspired by real discussions from:
r/nanny and r/parenting on Reddit
The Nannyhood blog and community discussions
Motherly articles on parenting and work-life balance
Hunny Nanny Agency client feedback and ongoing support work with physician families nationwide
Looking for support in finding or retaining a nanny who gets your life as a physician? Let’s talk. We work with families across the country who need more than “just childcare”—they need someone who understands the rhythm of medicine and the heart of family.
