Spain's has 12.7 nurses per patient which is the highest among nine countries looked at in the study just published in the prestigious medical journal The Lancet.
Researchers investigated the link between cuts to staffing numbers, nursing education levels and the mortality rate for people over 50 after several types of surgery.
The study found inpatients were 7 percent more likely to die for every extra patient a nurse had to take on. That's good news for Norway where each nurse takes care of 5.2 patients, or Ireland where that number is 6.9.
It should also sound warning bells in Spain where annual health funding was trimmed by 0.5 percent from 2009 to 2011 after years of increases.
But the Lancet study, which tracked over 400,000 patients in 2009–10, also shows patients have a better chance of survival if nurses have a local undergraduate university degree.
With every ten percent increase in the number of nurses with a bachelor degree, the post-surgery mortality rate actually drops 7 percent, the researcher found.
This implies "patients in hospitals in which 60 percent of nurses had bachelor’s degrees and nurses cared for an average of six patients would have almost 30 percent lower mortality than patients in hospitals in which only 30 percent of nurses had bachelor’s degrees and nurses cared for an average of eight patients," the study authors said.
And with Spain's nurses all holding the Spanish equivalent of an undergraduate university qualification this helps counteract the effect of the higher nurse-to-patient ratio.
The overall death rate was 1.3 percent at the 16 hospitals looked at in Spain, which was the average number for the nine study countries.
The best result — 1 percent — was achieved in Sweden (where there are 7.6 nurses for every patient), while figures of 1.5 percent were seen in Norway, Ireland and Switzerland.
But the study results may only provide cold comfort to Spain's nurses, who are now being asked to do more with less.
Some 20,000 nurses have lost their jobs in recent years because of spending cuts,
Many have left the country in a bid to find work, and around 5,000 Spanish nurses are thought to be working in Germany according to Spanish nursing union SATSE.
"Nursing is a so-called soft target because savings can be made quickly by reduction of nurse staffing whereas savings through improved efficiency are difficult to achieve," wrote the authors of the Lancet study.
Europe needs to focus on improving nursing education and ensure austerity measures do not threaten patient outcomes, the researchers argued.