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You'll know when it's time to hire a nanny. When you've gone through two or three babysitters who can't be relied on to work when you need them, or when you've exhausted your mother or mother-in-law with babysitting work, it's time to find a better solution. There are a few different ways of finding a nanny including the following:
Finding a nanny isn't hard, the trick is finding an appropriate, qualified, professional nanny. That's not to say a student isn't going to be a dedicated nanny for you, but the person you hire is going to be watching over your kids, so you want to make sure they know what they're doing and can handle any emergencies that might come up.