To analyze the effect of psychological nursing on the adverse emotions of conscious patients with severe burn in ICU. Methods A total of 100 conscious patients with severe burns who were treated in ICU of our hospital from February 2020 to February 2021 were selected as the research objects and randomly divided into control group and observation group, with 50 patients in each group. The control group was given routine nursing, and the observation group was given psychological nursing on the basis of the control group. The nursing satisfaction, emotional state, mental health and self-efficacy of the two groups were compared. Results The nursing satisfaction of the observation group was 96.00%, which was higher than 84.00% of the control group (P <0.05). After intervention, the scores of POMS in the observation group were higher than those in the control group (P <0.05). After intervention, the MHC-SF score and GSES score of the observation group were higher than those of the control group (P <0.05). Conclusion It is of great significance to carry out psychological nursing for conscious patients with severe burn in ICU. It can not only alleviate the adverse emotions of patients, but also improve the therapeutic effect and improve the quality of life of patients.