Cardiac surgery which includes coronary artery bypass grafting and heart valve surgery represents the most common classes of surgical procedures performed globally. Chest tube removal has been defined as a painful and frightening procedure for Intensive Care Units patients. Aim of the study: To evaluate the effect of designated nursing intervention on severity of pain and anxiety during chest tube removal among cardiac surgeries patients. Design: A quasi-experimental design is utilized. Sample: A purposive sampling of 60 adult patients from both genders who were randomly allocated and alternatively divided into two equal groups, study and control. Setting: The study was conducted in the cardio-thoracic Intensive Care Unit at Fayoum University Hospitals. Tools: Four tools were used for data collection, (I) a Structured Interviewing Questionnaire, (II) a Numerical Pain Rating Scale, (III) an Adapted McHill Questionnaire, and (IV) Hamilton Anxiety Scale. Results: This study showed that there was a highly statistical significant decrease of severity of pain and anxiety during chest tube removal after implementing the designated nursing intervention. Conclusion: It can be concluded that implementation of designated nursing intervention has a statistical significant effect on the severity of pain and anxiety during chest tube removal. Recommendations: the study recommends applying the designated nursing intervention to cardiac surgery patients during chest tube removal.