Me, too!!!!

There would be a dead husband buried under the house, and a fat life insurance policy helping to pay for childcare 'round these parts. Lol! Oh, wait. That was my inside voice.

I need to be spanked for not reading the entire thread before I posted, so I'm editing. The previous statement stands, however. I'm glad that you found a way to make it work, though!

I found that woman's business card ... she works with Cultural Care.I haven't actually used them, so I can't offer a definitive recommendation, but she seemed on-the-ball.

merri,

I am in my residency, and I am having the EXACT same issue as you.... how to cover early mornings, late evenings, and 1 full weekend a month of call. I have a great hands-on husband, but he is out of town sporadically for usually a week at a time. We dont have a plan on how to manage this yet!

I have been wracking my brain as to whether to do day care, and hire someone for pick up and to stay for an 2-3 hours in the evening. Another thought I have had is to have a live in nanny (in our TINY spare bedroom), and do a few days a week of day care if she can work longer hours on the other days. But that still doesnt cover me for call nights.
I feel pretty stuck... although female residents and physicians do this somehow...so I believe that there has to be a way! (other then a willing family member...which would be ideal)

if I figure out the magic combo, I will pass it on... in the mean time, would love to hear of creative ways that others manage childcare, with a slightly ABNORMAL schedule!

Thanks Emily -

oceanpearl - I'll let you know if I figure it out...

We don't even have a real room - the au pair would have to live in our downstairs den (which is very private, and essentially could be a bedroom).

Another bad part is that since both of our families live away - once we get an au pair... they will have no where to stay.

As far as the 45 hour work week... I was hoping that the au pair might be flexible... that is maybe one week work 20 hrs (when hubby home)... the next week 50-60 - (hubby not home)... I don't know. Some of my classmates have offered to babysit when they are in 4th year and I'm in 3rd - but of course I can't count on that.

It's depressing because this will be an ongoing issue and will get even worse during residency.

I spoke to a local agency - they said that their nannies ran $100 per day! I don't think we can afford that... I mean I still have 2 more years of 40K tuition to fork out...

This stinks!

I could absolutely be wrong here, but my sense (from my single conversation) is that work rules for au pairs come straight down from the State Department. In addition to the 45 hour weekly max, they can't work more than 10 hours/day and have to have at least 1.5 consecutive days off/week. It seems plausible that you could get someone who'd be happy to do 60 hours one week and 20 the next, but if it's *technically* against the rules (which, maybe it isn't; I could totally be wrong), it'd be tough to screen candidates for willingness to work that way, you know?

If you call an au pair agency and ask, would you mind sharing the answer? I'd be interested to know.

What about a college student (or preclinical med student) willing to sleep over on the nights you're on call and your husband is traveling?

Merri,
I hate to break this to you, but I actually don't think it's possible to have two parents with non-traditional work schedules and no family to help, unless you hire a full-time live-in nanny. And it can't be an au-pair from an agency, because they have too many rules on hours/day, etc. as mentioned above.

The problem is day care, most babysitters, or au-pairs won't be able to cover the early morning hours, late nights, overnights, weekends that you'll have to work in residency and in practice when you are on call. When I was first in practice, my husband had traditional hours and the first baby was no problem. If I needed to go in during the night, he was there. During the day, we used a variety of home daycare, babysitters, daycare center, etc. Occasionally I took her with me on rounds if I was stuck on a Saturday, but not too often, and it was distracting. Also not something you can do in med school or residency.

Two more children, a move, and a change in my husband's job later, and I had to make changes. His job now requires frequent travel like what you described. It's just not possible for me to have a regular practice with call. Occasionally I have had a neighbor high school student stay overnight, but that isn't something you can count on on a regular basis.

So for that and a variety of reasons, I changed jobs and now work in urgent care with regular hours that I can control based on his schedule.

My experience with lots of women physicians is that their husbands either stay home with the kids, work regular hours, or the physicians work part-time. I don't know anyone who has a full-time practice with call whose husband travels or works irregular hours.

Good luck to you, though. I hope something works out!

Agree with Lisa. I think I mentioned this in another post, or maybe somewhere in this thread. When my husband took ajob out of state that was supposed to last 6 weeks and ended up lasting 18 months, I kept my daytime in-home nanny and found a young woman to move in with us who had a regular day job and needed a place to stay for several months until her wedding. She lived and ate with us in exchange for coming straight home from work to relieve the daytime sitter and make dinner for the kids. Once I got home her time was her own, except she carried a pager if she went out (I did my own OB back then) and had to be immediately available if I was on call. If she had something important going on that couldn't be interrupted (Like tickets to a big concert or a family wedding) she told me in advance and I arranged other backup. We did that for over a year and it worked well. She got free room and board in exchange for about 10 hours of work a week.

Thanks for the ideas -

It's really worrying me. I'm supposed to go back to third year in July - and I'm just not sure how we are going to do it... plus this is going to be a continual issue through residency and once I start to practice. How can we afford this?! It makes me think that I can't afford to finish my training (but how can I afford not to - with the disgusting amount of debt we are in... hmmm wish I could get a bailout...)

Does anyone have experience with a full time nanny? If yes, how did you find her/him, what was the pay range? WHat about healthcare, does the family have to provide it?

I'll let you know if I make any progress...

I briefly considered a live-out nanny when I thought we weren't going to be able to find daycare. Here in my area (SF Bay Area), legal, experienced nannies run $18-20/hour plus taxes and benefits (definitely health insurance and paid vacation). The other day I met a nanny at the park who confided to me that she's "underpaid" at $18/hour, although she did have two kids to care for. Not sure about live-in, since we don't have space for that arrangement.

I've also been looking into the Boston nanny market. Looks like the going rate there is similar to here, $15-20/hour for a legal live-out nanny, with the expectation that you'll pay taxes and benefits. Live-in (again, legal) nannies appear to be more like $400-600/week. (Thus the appeal of the au pairs! Half the price!)

The nanny I met in the park said she found her current employers through Craig's List, although she's also worked with agencies in the past. I am astonished by how expensive the agencies are ... 1-3 months salary! Yikes. Also expensive in Boston; I found one agency that charges > $3K for placement of a full-time person.

Depending on how you feel about it, undocumented/under the table is cheaper, for sure. (Skip if you're ever planning to be Surgeon General!) I have friends who employ a fabulous woman to care for their son. She's not documented and they pay her under the table, obviously. I think she started at $12/hour, but she's so great that they now pay her more like $15 or $17. But they also save on the payroll taxes. I don't think they pay for her health insurance, but I'm not sure. I do know that their relationship with her is somewhat complicated and they compensate her additionally with needed favors (as in, extra cash) from time to time. But that may happen with any nanny, I don't really know.

I can only assume there's a broad range of prices across the country. Hopefully you live in a moderate COLA. I really feel for you. Any chance your husband can switch jobs or pull back from all the travel for awhile?

I may have found a live out nanny :crossfingers:
She's a lovely Polish retired woman - who is totally sweet, loving - with great references.
Have to finish discussing pay... she was asking for vacation and sick... not sure I can do that... but really want to keep a good person. :crossfingers: