D&D 5E Falling below zero HP and Exhaustion mechanic

[Retreater]

Or a low to middling npc followsa drop with a chill touch that not only gives anothere death save fail but also blocks heals for a bit?

There are reasons for minions.

I would actually prefer to address this with rules rather than have to continuously tinker with encounters and add creatures that wouldn't fit the narrative of the story. In this specific case, the dragon flying overhead would have killed its own minions with its breath attack, so that wouldn't work.
Besides, it just seems cheap to have minions running around to deal attacks to kill dying opponents.

 

[Gadget]

Perhaps someone who reaches zero hitpoints is slowed for the rest of the encounter after they are brought back on their feet? It still increases the likelihood that they'll drop back down to zero again due to the penalty, but it least it is not a 'rest of the day' type of penalty that may complain about.

 

[5ekyu]

I would actually prefer to address this with rules rather than have to continuously tinker with encounters and add creatures that wouldn't fit the narrative of the story. In this specific case, the dragon flying overhead would have killed its own minions with its breath attack, so that wouldn't work.
Besides, it just seems cheap to have minions running around to deal attacks to kill dying opponents.

This is part of the cognitive divergence.

To the PCs hitting zero does not mean dead, it means st risk or vulnerable - it's the equivalent of "check" or "atari". It demands immediate attention.

But on the other side of that same table, NPCs on the opposing side in that same world are "supposed" to treat the downed PC as of it had been removed from play. Its "cheap" to have the NPCs spend even a fraction of the planning and organizing to exploit the "vulnerable" nature of a down PC as the PCs and players spend on how yo recover from it quickly.

Is it cheap also to have higher end mages plan ways to get spells off in spite of counterspell? Are they supposed to just blindly toss high slots into counterspell defeats to avoid bring considered cheap too?

There are a lot of things that make teams and minions not just decent ideas but tactically savvy. Whether its some hidden kobolds shamans looking to chill touch from cover or a image's apprentice throwing some shade (almost literally) to let the wizard get his spells off not countered, it's not in sync for the two sides to play in different worlds.

 

[Bacon Bits]

We have not, in general, experienced a whack-a-mole problem. That is not to say that we haven't had combats where the same PC has dropped to 0 hp in consecutive rounds, only to be revived by magical healing. We just don't have a problem with it when that happens.

First, nobody is actually dead when they hit 0 hp. Second, nobody is recovering in combat without some supernatural aid or the Healer feat, so it doesn't really run afoul of ludo-narrative dissonance to us. Third, it's not particularly different than D&D has been for the past 40 years.

Fourth, exhaustion as a mechanic is extremely punishing, and punishing the party for taking too much damage when they're ostensibly still in the middle of losing that same combat seems questionable. It's just asking the combat to snowball into a TPK. I'm sure some tables want that feeling where failure makes future failure more likely, but I don't think that's D&D's style. I also don't think it's particularly engaging from a narrative standpoint. Certainly not compared against the narrative of a ragtag team of adventurers rallying to overcome great odds and near tragedy. In general, we find being knocked prone, losing any spell concentration or ongoing effects like rage, often losing a turn, and consuming the healer's spell slot to be enough of a cost.

If I wanted to make healing costlier or make extended adventuring more dangerous, I would adjust how easily it is for the PCs to long rest, or adjust their maximum HP down after level 10 or so.

 

[iserith]

We have not, in general, experienced a whack-a-mole problem. That is not to say that we haven't had combats where the same PC has dropped to 0 hp in consecutive rounds, only to be revived by magical healing. We just don't have a problem with it when that happens.

First, nobody is actually dead when they hit 0 hp. Second, nobody is recovering in combat without some supernatural aid or the Healer feat, so it doesn't really run afoul of ludo-narrative dissonance to us. Third, it's not particularly different than D&D has been for the past 40 years.

Fourth, exhaustion as a mechanic is extremely punishing, and punishing the party for taking too much damage when they're ostensibly still in the middle of losing that same combat seems questionable. It's just asking the combat to snowball into a TPK. I'm sure some tables want that feeling where failure makes future failure more likely, but I don't think that's D&D's style. I also don't think it's particularly engaging from a narrative standpoint. Certainly not compared against the narrative of a ragtag team of adventurers rallying to overcome great odds and near tragedy. In general, we find being knocked prone, losing any spell concentration or ongoing effects like rage, often losing a turn, and consuming the healer's spell slot to be enough of a cost.

If I wanted to make healing costlier or make extended adventuring more dangerous, I would adjust how easily it is for the PCs to long rest, or adjust their maximum HP down after level 10 or so.

Right, the real trick with a house rule is what kind of outcomes it will produce in play and whether those outcomes actually address the problem. The OP's proposed house rule means the PCs may long rest much more frequently if they can. Is that really what is desired? It may create an incentive to not fall below 0 hit points which could increase in-combat healing prior to PCs going unconscious, but I doubt this will actually happen. It's generally more efficient to do damage to the monster than it is to heal comrades who aren't dying.

 

[Oofta]

It's not that hard to kill PCs if you really want to do so. Just double tapping will do it most of the time. Healer causing grief? Focus fire.

But personally I don't have a problem with whack a mole. Knocking PCs unconscious removed actions and puts the fear of God into them. Isn't that the point?

 

[robus]

Please let me know your thoughts, and especially any experience you've had with this option.

You should check out Eric Pommer’s Wounds PDF as he tackled this exact topic:

Wounds PDF

Sadly his original site seems kaput.

 

[Yaarel]

I want something like Exhaustion, but it has to be rethought.

For example, an injury that causes deafness or breaks an arm, wouldnt slow speed.

Also, increasing levels of injury would take longer to recover − from hours to days to weeks to months, even a year or two, or be a permanent disability. Also, it might work better if the injury level is instead of death. Then death is the highest level of the injury system.

It makes narrative sense for a hit that does ‘real’ damage, at zero, to have a ‘real’ consequence.

And I find it distracting that there is no such thing as broken bones in D&D.

But the Exhaustion rules as-is, dont work well for the purpose of representing an enduring injury.