Abstract
Healthcare workers are street-level bureaucrats (H-SLBs) who are expected to perform according to specific roles. The COVID-19 pandemic has strained healthcare systems to unprecedented levels. The acute scarcity of medical resources has left H-SLBs exposed to a higher risk of personal harm and has them making an increased number of decisions in the apportionment of scarce life-saving treatment. The article studies the case of H-SLBs in Mexico to understand the impact of the crisis on their roles. The pandemic provides an opportunity to observe role changes during crisis. Their roles, derived from two policy guidelines, and from the de facto roles that H-SLBs shared in the storytelling interviews, are coded, analyzed, and compared. Findings suggest two main roles, client-processing and resource-rationing, guide the set of sub-roles H-SLBs perform to cope with the challenges brought by the COVID-19 pandemic. Note: In the interests of space, street-level theory and the pandemic context underpinning the articles for this Special Issue are discussed in detail in the Introduction to the Issue.
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