If you have a nanny, nanny share, or small in-home daycare, how do you deal with your childcare provider's sickness, personal appointments, and vacations?

We are dealing with appointments and sickness and it's hard because DH is a teacher, so taking off is not simple, and I am at a job where I don't have a lot of time to take off. I had to get LO last Friday because our nanny was sick and I took her to work with me so I could finish up. This is not something I can do on a regular basis but I had a deadline and I work close to the nanny share while DH is an hour away. DH had to take off on Monday because our nanny was still sick.

There was a funeral last month and some green card & health insurance stuff over the summer. It's not a ton, but it's very inconvenient because she's our sole provider. Next week she has a doctor's appointment in the morning and I just can't take off. Luckily, my mother has the day off and is going to come over to watch LO.

Do you have back-up day care? Do you just split the time up? I am thinking that we need to find back-up childcare now. In my previous job I had SO MUCH time that it wasn't an issue.