Objective To explore the effect of phased reffned nursing on the psychological status of emergency patients with facial trauma undergoing plastic and aesthetic repair. Methods A total of 110 patients with facial trauma undergoing plastic and aesthetic repair admitted to the Emergency Department of our hospital from January 2023 to February 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 55 patients in each group. The control group was given conventional nursing, and the observation group was given phased reffned nursing. The injury assessment time, surgical preparation time, pain intensity, psychological status and complication rate were compared between the two groups. Results The injury assessment time and surgical preparation time in the observation group were shorter than those in the control group (P<0.05). After nursing, the VAS score in the observation group was lower than that in the control group (P<0.05). After nursing, the scores of SAS and SDS in the observation group were lower than those in the control group (P<0.05). The incidence of complications in the observation group (3.64%) was lower than that in the control group (14.55%) (P<0.05). Conclusion For emergency patients with facial trauma undergoing plastic and aesthetic repair, phased reffned nursing intervention can shorten the time of injury assessment and surgical preparation, effectively relieve postoperative pain, improve patients’ emotions of anxiety and depression, and reduce the incidence of complications.