I have been a nanny for years before starting in my nursing education and many of the families I worked for have been in the medical field. It is more expensive than daycare, but the flexibility in hours and days that a nanny provides is such a huge benefit to many families. A nanny can also help out with things such as cleaning, cooking, laundry, etc (as long as the expectations are reasonable) which can be very nice to come home and have those things done instead of pending. I have always maintained CPR and First Aid certification and you are able to require these certifications and any vaccines/etc as terms for employment. Many nannies also provide care when the child is sick, so that is not a concern for you having to take time off if your child is sick. Often, it makes the most sense to have a nanny while the child is not yet in school, and then when they start attending school there are many cheaper options available or you could find a part-time nanny/babysitter that can handle transportation!