Tips for Managing Nanny and Childcare Transitions

How to Navigate Change in the Middle of a Chaotic Career and a Growing Family

For physician families, transitions are nothing new. Residency, fellowship, unexpected relocations, schedule changes that no one outside of the hospital world can fully comprehend — these shifts are part of your life. But when the change involves your child’s caregiver — whether a nanny, daycare provider, or babysitter — that transition hits differently.

Because this time, the ripple effects of a professional shift land at home.

And if you’re anything like the many physicians we've spoken to across the country, you’ve likely asked yourself:
“How can we make this easier on our kids? On our nanny? On us?”

Whether your trusted nanny is moving on, your work schedule is changing, or you’re hiring your very first childcare provider, transitions are inevitable. But they don’t have to be chaotic. They can be thoughtful, gentle, and even growth-oriented for your child — and for you.

Here’s how physician families can thoughtfully manage nanny and childcare transitions — even amid 24-hour call shifts and post-op notes.

1. Give Yourself (and Your Child) Permission to Feel Things

Before we dive into logistics, let’s start with something more important: your emotions. Transitions in childcare stir up a surprising amount of grief and guilt. For many parents, especially those in high-pressure professions like medicine, a nanny isn’t just an employee. They’re a lifeline. A co-parent. The person who witnessed the first wobbly steps and the million micro-milestones in between.

It’s normal to grieve when they leave.

Parents have described feeling “as heartbroken as when I left my toddler at daycare for the first time” when saying goodbye to a nanny. Some even shared that their children experienced a true mourning period — refusing to engage with the new nanny, crying during handoffs, or acting out in unfamiliar ways. This isn’t a sign that you’ve done anything wrong. It’s a sign that deep bonds were formed. That your child felt safe, seen, and loved.

Give that process room.

Tip: If you’re the one initiating the change (like letting a nanny go due to scheduling changes or cost), it’s still okay to feel sadness or guilt. Just because something is “logistically necessary” doesn’t mean it won’t be emotionally complicated.

2. Prepare Your Child for the Change (No Matter Their Age)

Even toddlers — yes, even your 18-month-old — can sense when something is changing. And while they may not understand the words “We’re transitioning to a new nanny,” they absolutely notice the energy behind the change.

So don’t wait until the new nanny shows up at the door.

Instead:

• Start talking about the change early. Even if you’re still finalizing details, say: “We’re going to have someone new helping take care of you soon. I’ll tell you more as we get closer.”

• Use storybooks or dolls to role-play the idea of a new caregiver. One mom in a dual-physician household created a “New Friend” week — letting their toddler’s favorite stuffed animals get introduced to the concept of a new helper.

• Let your current nanny be part of the conversation. If the nanny is leaving on good terms, having them introduce the idea of someone new can make it feel less like a loss and more like a handoff.

3. If Possible, Plan for an Overlap Week

Not every family can make this work financially or logistically, but if you can afford a week (or even a few days) where your outgoing and incoming nanny overlap — do it.

Here’s why it matters:

• Your child sees both adults in the same space, which builds trust.

• The outgoing nanny can demonstrate routines, quirks, and cues in real-time.

• It creates continuity, which kids (and their nervous systems) crave.

Physician families in particular have praised this transition tactic in forums: “Our toddler watched our current nanny teachthe new nanny how she liked her sandwich cut. That moment gave her so much confidence — she wasn’t starting from scratch, and neither were we.”

4. Create a “Transition Binder” (Or Digital Folder)

If you're hiring a new nanny, take some time to build a simple guide to your household. You don’t have to go full Marie Kondo, but a clear, shareable resource can reduce everyone’s anxiety.

What to include:

• Daily schedule (including when naps actually happen, not just when you’d like them to)

• Favorite meals and allergies

• Bedtime routines

• Screentime rules

• Emergency contacts and pediatrician info

• Family values (yes, these matter — for example, “We always greet each other with a hug,” or “We try not to raise our voices in frustration”)

Many physician families have used Google Docs for this so it can be updated in real time. Others prefer a printed binder. One family even used voice notes — recording themselves walking through routines during a night shift lull.

5. Hold a “Welcome Session” — Even If It’s Virtual

Once your new nanny starts, carve out intentional time to introduce them to your child in a fun, low-pressure way.

This doesn’t have to be a big production. Think:

• A trip to the neighborhood playground with both parents present

• Pancake breakfast where the nanny helps pour syrup or pick toppings

• A walk around the block together after school drop-off

This moment isn’t about training — it’s about relationship-building. Especially for parents who can't be home often, this is a chance for your child to see you choose this new person. That sense of parental approval and unity can go a long way in easing anxiety.

6. Expect a Regression or Two — It’s Normal

During childcare transitions, even the most well-adjusted children may experience behavioral regressions. More clinginess. Accidents. Night wakings. Separation anxiety that seemed to have vanished months ago.

This isn’t failure — it’s their nervous system adjusting.

You can help by:

• Keeping as many other routines steady as possible (bath time, dinner time, etc.)

• Offering extra physical touch and verbal reassurance

• Letting the nanny know regressions are expected and not necessarily a sign that they’re doing something wrong

One mom shared, “We thought our 4-year-old would be the easy one, but she started having tummy aches every morning. Her pediatrician gently reminded us this was likely emotional. It passed after a few weeks once she felt safe again.”

7. For Physician Parents: Communicate with Your Nanny Like a Teammate

With shift work, emergencies, and pager interruptions, it’s not always easy to have consistent face-to-face time with your nanny. But that doesn't mean communication has to suffer.

What works well for busy medical families:

• A shared Google Calendar with important notes or schedule shifts

• A running message thread (text, Slack, or WhatsApp) for check-ins

• A weekly wrap-up email or voice memo to recap how things are going

• Using a shared notebook or dry-erase board at home for quick notes

Transitions require even more communication than usual. Let your nanny know your child’s emotional state, upcoming changes in routines, or anything they should watch for. And invite their feedback too — they’ll likely notice signs of stress or resilience before you do.

8. Be Honest with Your Kids — But Keep It Age-Appropriate

If your nanny is leaving (especially if it's not a happy departure), it can be tricky to explain. Kids pick up on tension fast. It’s okay to be honest without over-explaining.

Some language you might try:

• For toddlers: “Sara isn’t going to be taking care of you anymore, but we’ll still have lots of fun with [new nanny].”

• For preschoolers: “Sometimes grownups change jobs just like parents do. We’re going to miss her, and it’s okay to feel sad. We’re also going to meet someone new.”

• For older kids: “There were some things that weren’t working well for our family anymore, and we made the choice to make a change. That doesn’t mean Sara was a bad person. It just means this is what’s best for our home right now.”

Keep it simple, loving, and avoid placing blame if at all possible.

9. Let the Goodbye Be a Ceremony, Not a Sudden Exit

If the nanny is leaving on good terms, make space for a goodbye ritual. These little gestures create closure and allow your child to process the change in a healthy way.

Ideas include:

• A handmade card or picture book of memories

• A farewell picnic at the park

• A “last day” ice cream run or pajama breakfast

• A video message to watch later (for younger children)

One family even threw a “Thank You Nanny” party, inviting their nanny’s friends and family. It gave their kids a sense that this person they love is still cared for — and that transitions can be joyful, too.

10. If You're Still in the Search Phase — Don’t Rush It

We know it’s hard. Especially when your partner is on call, your shifts are overlapping, and daycare isn’t an option.

But finding the right nanny — especially after a beloved one leaves — is worth doing right.

Families have shared stories of rushing to hire someone only to realize weeks later it wasn’t the right fit. If you can bridge the gap with a grandparent, a temp nanny, or even a patchwork schedule between parents, it’s worth slowing down.

Look for:

• Emotional warmth

• Flexibility with unpredictable medical schedules

• Reliability under pressure

• Alignment with your parenting style

Even a brief “trial week” can save you from a long-term mismatch.

Final Thoughts: Change Is Hard, But It’s Also Growth

If you’re in the thick of a childcare transition right now, we see you. You’re juggling critical decisions at work and deeply personal ones at home — often without enough sleep or time to process either.

But transitions — while uncomfortable — are also powerful opportunities for growth.

Your child is learning how to adapt. How to say goodbye with grace. How to trust new people. And you’re learning, too: how to advocate for your family’s needs, how to honor relationships, and how to navigate change with presence, even on call.

And when you find the right fit? It’s magic.

Your home feels lighter. Your child is secure. And you get to show up for your patients and your family — with a little less guilt, and a lot more peace.

Need help finding the right nanny for your next chapter? Whether you’re saying goodbye, starting fresh, or just anticipating change on the horizon, we’re here to help make it easier. We’ve supported hundreds of physician families through this exact moment — and we’d love to do the same for yours.

Credits:
This blog is inspired by shared experiences across physician parenting forums including Reddit (r/Parenting, r/medicine, r/Mommit) and family lifestyle blogs that center real parent transitions and household support.