OP, any update?

I don't think scheduling the trip shows poor judgement - it just suggests that she desperately needed/wanted to visit her family for reasons unknown to us. HOWEVER, the trade-off for your flexibility in allowing that is her taking any necessary sick days unpaid.

OP, I agree with the early PP who suggested explaining this to her (although you shouldn't have to) and reiterating your policy about her coming to work sick (or not). If you can let her work other hours (date night, weekend) offer them to her, but any sick days she needs until her contract renews should remain unpaid. It's unfortunate for her but it is the risk she took. FWIW I am a nanny and have done the same when I needed to (family emergency), was grateful to my employers for allowing me to do so, and understood the consequence of falling ill later would be a loss of income.

You women can't decide what you want. A nanny calls out sick, you're pissed and would rather she let you make the call. She comes to work ill and she's gaming the system. She was willing to work OP and you sent her home. Your call, your dime.

It sounds like you didn't read the thread, or maybe you don't understand the OP's question.

The OP doesn't want the nanny working when she's sick. The problem is, nanny has used up all her PTO, on her choice to spend it all on a single trip. Thus, she has no sick time left. Nanny initiated the agreement and understood she would have no PTO left. Therefore, the OP is not responsible for paying her on the day she is too sick to work. Nanny gambled on her PTO needs, and lost.

Nanny made a very irresponsible choice when she planned the trip, and made a second irresponsible decision trying to come to work very sick. If I were OP, this would be a cause for concern about her judgment.

I would NOT pay her for today - it just sends the message that as long as she shows up, she'll get paid. So, she'll just keep coming to work whenever she's sick, and risk getting your child sick. I think you're better off sending the message that if she's sick, she might as well stay home from the get-go, because, per your agreement, she's not getting paid.

This. She made an agreement with you and knew the consequences of that choice to her PTO.

"A nanny calls out sick, you're pissed and would rather she let you make the call. "

I have heard nannies say this on this board before but never an MB. I do not expect my nanny to come to work really sick and make me decide if she needs a sick day - that's really bad judgement on her part and any MB that expects that is nutso. OP's nanny was 100% gaming the system by coming to work very sick after she'd spent down her sick leave by using it all up as vacation time.

You women can't decide what you want. A nanny calls out sick, you're pissed and would rather she let you make the call. She comes to work ill and she's gaming the system. She was willing to work OP and you sent her home. Your call, your dime.

I agree with the posters who say to let her make up the hours at another time, if you actually need her and can afford it, that is.

When she is well and returns to work, you need to sit down with her and spell all this out. She needs to understand that when she's out, you have to have coverage, and that costs you money you don't have.