Objective To explore the effect of operating room nursing based on the ERAS concept on the psychological status and pain intensity in patients undergoing burn skin grafting. Methods A total of 60 patients undergoing burn skin grafting in Jiangdu People's Hospital of Yangzhou from January 2022 to June 2025 were selected, and they were divided into the reference group and the observation group by the random number table method, with 30 patients in each group. The reference group received conventional nursing, and the observation group received operating room nursing based on the ERAS concept on the basis of the reference group. The postoperative recovery status, psychological status, complication rate and pain intensity were compared between the two groups. Results The first ambulation time, wound healing time and hospitalization time in the observation group were shorter than those in the reference group (P <0.05). The scores of SAS and SDS in the observation group after nursing were lower than those in the reference group (P <0.05). The incidence of complications in the observation group (3.33%) was lower than that in the reference group (20.00%) (P <0.05). The VAS score of the observation group after nursing was lower than that in the reference group (P <0.05). Conclusion The application of operating room nursing based on the ERAS concept can effectively accelerate the postoperative recovery of patients undergoing burn skin grafting, synchronously improve their psychological status, reduce pain, and decrease the incidence of complications.