Objective: To explore the effect of implementing a time-sensitive incentive model combined with specialized rehabilitation nursing in patients with severe pneumonia and respiratory failure. Methods: Seventy-eight patients with severe pneumonia and respiratory failure admitted from January 2024 to February 2025 were selected and randomly divided into two groups using a computer-based random drawing method. The control group (39 patients) received routine nursing, while the observation group (39 patients) received a time-sensitive incentive model combined with specialized rehabilitation nursing. Lung function and adverse emotional states were compared between the two groups. Results: After 2 weeks of nursing, the lung function of the observation group was higher than that of the control group (P < 0.05), and the adverse emotional states of the observation group were lower than those of the control group (P < 0.05). Conclusion: Implementing a time-sensitive incentive model combined with specialized rehabilitation nursing in patients with severe pneumonia and respiratory failure can improve lung function and emotional state.