Falling below zero HP and Exhaustion mechanic

Spohedus

Explorer
I have long been bothered by the whack-a-mole nature of falling below zero HP in 5th edition for many of the same reasons that have been discussed on this forum for five years. Here's my question: has anyone tried a house rule to utilize the exhaustion mechanic? Here's an example I'm considering:

When you become conscious after falling to zero HP, you have five levels of Exhaustion. You may roll a Constitution saving throw at the end of each of your turns to remove a level of exhaustion until you only have one level of exhaustion more than the level of exhaustion you had before falling to zero HP. Finishing a long rest removes one level of exhaustion, provided that you also ingest some food and drink.

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

Adventurer
The primary problem with using Exhaustion is that it's nearly impossible to get rid of without taking 1 or more Long Rests. This means that any time a party member drops to 0 HP, the adventuring day is usually done. If the wack-a-mole problem is an issue for you, you can have characters that recover HP remain unconscious until someone takes an action to wake them or they take damage (and somehow remain above 0 HP).
 

dnd4vr

Adventurer
Yeah, the whack-a-mole issue is an issue for many tables. We use exhaustion as well and got rid of death saves in the process.

Our house-rule is

When you reach 0 HP you fall unconscious for 1d4 hours and suffer a level of exhaustion. You can make a Constitution check (NOT A SAVE) with a DC equal to 10 or half the damage taken (similar to a spell concentration check) to avoid the level of exhaustion.

If you take damage while unconscious, you automatically suffer a level of exhaustion. If you take damage during the round in total of your maximum HP, you die.

If your receive healing and your HP is increased to 1 or higher, you remain unconscious. A Lesser Restortation spell will restore you to consciousness, as will a DC 20 Wisdom (Medicine) check and the use of a Healer's Kit. You also regain consciousness if you are healed to your maximum HP.

You die if you accumulate six levels of exhaustion (as normal) or if you suffer damage sufficient to exceed your maximum HP (also normal rule).

We also use the lingering injury rules in the DMG and massive damage rules in there as well.

As to your idea, it is sort of the reverse, huh? Starting at five levels of exhaustion and possible recovering some through CON saves. Oh, and what is the DC for the CON save? You don't say.

Just to make sure I have it right let's do an example. I am going to refer to a level of exhaustion as 1 EL (1 exhaustion level). So, five levels of exhaustion would be 5 EL.

I have no exhaustion (0 EL) and fall to 0 HP. I am at 5 EL (near dead) at this point. I make CON saves each round until I am at 1 EL. I am healed up to full HP but still have 1EL. Later on, I go to 0 HP again. I am at 5 EL again, but this time I can only recover to 2 EL (one worse than before). Finally, we return to town and I gain rest, requiring two long rests to remove the 2 EL.

I think it might work fine. Personally, going in the other direction could work as well and is the approach I would try, but that is only a matter of preference.

If you don't mind the gritty feel of the game, I would try it. I think going to 0 HP SHOULD be a very drastic thing and in 5E, it just usually isn't.
 

tetrasodium

Explorer
I tried the injuries mechanic in moregraves misc140, but got massive pushback from dndbeyond's complete inability to handle it (much like everything else) and eventually had to drop it because I expected my plsyers to trak their own injuries instead of the g both tracking & constantly reminding them. In the end I went with persistent death saves & fate points from darker dungeons

In a nutshell, a long rest clears only one death save. Everyone starts with one fate point & the group can get a fate point for doing especially heroic stuff, but they need to decide who gets that one point. Spending a fate point allows a PC who by all rights should be dead to survive like comic/action movie heroes... everyone thought john was dead from that fireball & yea he's having a terrible day, but he was just mostly dead & managed to survive.

Also in there is a "fatigue" mechanic that is somewhere between stun/shaken & exhaustion that works pretty well. Unfortunately ddb doesn't even support the optional phb/dmg mechanics so good luck if your players are attached to it.
 

Don Durito

Explorer
I made an alternative exhaustion mechanic here which is not so punishing the party can't continue on.

But really part of the issue is only recovering one level per long rest. This just seems like the wrong end of the stick. Everything else recovers on a long rest, so should exhaustion. If you want to be able to make attrition work across more than one day you need to make it harder to long rest anyway.

If your long rests take a week, or can only take place in civilisation, then you can still have exhaustion as a threat during wilderness adventures.

But there's an inherent tension at work here. It seems the issue with whack-a-mole is that it makes injury feel trivial. Once you start making exhaustion apply the issue is it doesn't. So the party will want to long rest - but if you want the injury to feel real - then they probably should!
 

Doc_Klueless

Doors and Corners
I use the common houserule of One Level of Exhaustion each time a PC dips below 0 HP. I've seldom had a PC drop below 0 HP more than once per encounter.

The first level of Exhaustion isn't really that punishing (Disadvantage on Ability Checks) if people remember that Attack rolls and Saving Throws are NOT Ability Checks (per Sage Advice). It's also why Level Three calls out Attack Rolls and Saving Throws.

Are attack rolls and saving throws basically specialized ability checks?
They aren’t. It’s easy to mistake the three rolls as three faces of the same thing, because they each involve rolling a d20, adding any modifiers, and comparing the total to a Difficulty Class, and they’re all subject to advantage and disadvantage. In short, they share the same procedure for determining success or failure.

Despite this common procedure, the three rolls are separate from each other. If something in the game, like the guidance spell, affects one of them, the other two aren’t affected unless the rules specifically say so.


The primary problem with using Exhaustion is that it's nearly impossible to get rid of without taking 1 or more Long Rests. This means that any time a party member drops to 0 HP, the adventuring day is usually done.
Yeah. It's definitely a play-style that might not mesh with everyone. We like it, but we can be weird. Heh.

Also:

It had me come up with Vitality Potions that cure levels of Exhaustion (basic 1d4, Greater 1d4+1, Superior 1d4+2, Supreme 1d4+3). They're expensive though.

Greater Restoration can also remove a level of Exhaustion per the rules. We've house ruled that Healing Domain Clerics add +1 level of Exhaustion removed for each of the Restoration spells.

We've also kinda houseruled sorta that the better accommodations you stay in remove increased levels of Exhaustion up to 3 levels per night. So Squalid & Poor (camping tents, sleeping rolls out in the open, etc. fall in here) removes 1 level, Modest and Comfortable (Tiny Hut falls in here) removes 2 levels, Wealthy & Aristocratic (Magnificent Mansion is in here) removes 3 levels.
 

GlassJaw

Explorer
Although on second read, I would reduce the number of exhaustion levels for those potions since there are only 5 levels. Not sure the random roll is adding much gameplay either. Just have each potion remove 1 level of exhaustion as the quality of option improves: 1, 2, 3, 4 for Basic to Supreme.
 

Doc_Klueless

Doors and Corners
Although on second read, I would reduce the number of exhaustion levels for those potions since there are only 5 levels. Not sure the random roll is adding much gameplay either. Just have each potion remove 1 level of exhaustion as the quality of option improves: 1, 2, 3, 4 for Basic to Supreme.
It's just to sorta kinda mimic Healing Potions. The randomness doesn't serve any other purpose.

Like I said: We're kinda weird. ;)

:ROFLMAO::LOL:

But your idea would also work great!

You DID get me thinking, though. I think next time we play, I'll float: Basic 1d4-2 , Greater 1d4-1, Superior 1d4, Supreme 1d4+1. Minimum 1 level. I suspect, though, that we'll keep it the same as it just works for us.
 

Blue

Orcus on a bad hair day
Oh gods, please google the half dozen threads where this exact idea has already been discussed to death.

1. The first thing exhaustion does is make you have disadvantage on skill rolls. Skill roles are the #1 mechanical interface for every other pillar of play besides combat. So dropping in combat will make you want to solve more things with combat, because you now suck at everything else for the rest of the day.

Solutions seen:
A. Don't use exhaustion.
B. Redo the exhaustion chart to be longer and have less effect-everything options first.
C. Have that specific type of exhaustion go away with a short rest.

2. Exhaustion is really hard to get rid of. You will suck for the rest of the day with just one, but once you have more it gets even uglier. Multiple days down, and you still have the chance to get more. Heck, in a battle with area of effects going off, the worst thing a character could do would be to heal you, since you'll go down again soon and then have two levels of exhaustion.

Solutions seen:
A. Don't use exhaustion.
B. Give more ways to recover exhaustion during the day & recover more exhaustion with a long rest.

3. Some characters specifically put themselves at more risk for the good of the party. Consider the melee fighter vs. the archer fighter. Both based on the same chassis, but the one trying to be a front line so the glass cannons don't get squished is more likely to go down. You you're providing a dis-intensive to playing certain types of characters.

Solution:
A. Don't penalize characters for taking one for the team in the first place.
B. Grant buffs to certain types of characters to offset the nerfs. Alternately allow those characters to ignore the first X levels of penalty. Note that this is not by class, so figuring out whom to grant is non-trivial.

4. D&D is a team game, and a game with randomness. Going down is usually not the sole fault of player who's character goes down. A giant with a crit, a healer who picks the wrong target to heal, a tank out of position so your wizard gets closed with. Yet the penalty is that the single character will suck at all skill checks for the rest of the day.

Solutions:
A. Recognize that characters will go down outside their control and don't de-buff them for the rest of the day *at least) for it.

The easiest solution that fits all of these is to give some other penalty that only lasts for the combat they went down in.
 

5ekyu

Adventurer
I use the common houserule of One Level of Exhaustion each time a PC dips below 0 HP. I've seldom had a PC drop below 0 HP more than once per encounter.

The first level of Exhaustion isn't really that punishing (Disadvantage on Ability Checks) if people remember that Attack rolls and Saving Throws are NOT Ability Checks (per Sage Advice). It's also why Level Three calls out Attack Rolls and Saving Throws.

Are attack rolls and saving throws basically specialized ability checks?
They aren’t. It’s easy to mistake the three rolls as three faces of the same thing, because they each involve rolling a d20, adding any modifiers, and comparing the total to a Difficulty Class, and they’re all subject to advantage and disadvantage. In short, they share the same procedure for determining success or failure.

Despite this common procedure, the three rolls are separate from each other. If something in the game, like the guidance spell, affects one of them, the other two aren’t affected unless the rules specifically say so.


Yeah. It's definitely a play-style that might not mesh with everyone. We like it, but we can be weird. Heh.

Also:

It had me come up with Vitality Potions that cure levels of Exhaustion (basic 1d4, Greater 1d4+1, Superior 1d4+2, Supreme 1d4+3). They're expensive though.

Greater Restoration can also remove a level of Exhaustion per the rules. We've house ruled that Healing Domain Clerics add +1 level of Exhaustion removed for each of the Restoration spells.

We've also kinda houseruled sorta that the better accommodations you stay in remove increased levels of Exhaustion up to 3 levels per night. So Squalid & Poor (camping tents, sleeping rolls out in the open, etc. fall in here) removes 1 level, Modest and Comfortable (Tiny Hut falls in here) removes 2 levels, Wealthy & Aristocratic (Magnificent Mansion is in here) removes 3 levels.
Yup. I think one of the bigger whammies for exhaustion 1 is the disad on perceptions and initiative. Those combine to be frequently a serious hit for encounter starts.

Not surprised to see adding ways to clear exhaustion when you add more ways to get it. Seems a common pairing.
 

iserith

Magic Wordsmith
How often are PCs dropping to 0 hp in your game such that a house rule is needed? My experience is that it doesn't happen very often once past apprentice tier and my challenges can be very difficult.
 

5ekyu

Adventurer
Oh gods, please google the half dozen threads where this exact idea has already been discussed to death.

1. The first thing exhaustion does is make you have disadvantage on skill rolls. Skill roles are the #1 mechanical interface for every other pillar of play besides combat. So dropping in combat will make you want to solve more things with combat, because you now suck at everything else for the rest of the day.

Solutions seen:
A. Don't use exhaustion.
B. Redo the exhaustion chart to be longer and have less effect-everything options first.
C. Have that specific type of exhaustion go away with a short rest.

2. Exhaustion is really hard to get rid of. You will suck for the rest of the day with just one, but once you have more it gets even uglier. Multiple days down, and you still have the chance to get more. Heck, in a battle with area of effects going off, the worst thing a character could do would be to heal you, since you'll go down again soon and then have two levels of exhaustion.

Solutions seen:
A. Don't use exhaustion.
B. Give more ways to recover exhaustion during the day & recover more exhaustion with a long rest.

3. Some characters specifically put themselves at more risk for the good of the party. Consider the melee fighter vs. the archer fighter. Both based on the same chassis, but the one trying to be a front line so the glass cannons don't get squished is more likely to go down. You you're providing a dis-intensive to playing certain types of characters.

Solution:
A. Don't penalize characters for taking one for the team in the first place.
B. Grant buffs to certain types of characters to offset the nerfs. Alternately allow those characters to ignore the first X levels of penalty. Note that this is not by class, so figuring out whom to grant is non-trivial.

4. D&D is a team game, and a game with randomness. Going down is usually not the sole fault of player who's character goes down. A giant with a crit, a healer who picks the wrong target to heal, a tank out of position so your wizard gets closed with. Yet the penalty is that the single character will suck at all skill checks for the rest of the day.

Solutions:
A. Recognize that characters will go down outside their control and don't de-buff them for the rest of the day *at least) for it.

The easiest solution that fits all of these is to give some other penalty that only lasts for the combat they went down in.
Cannot argue with any of these and will emphasize #4. Most often PCs going to zero is not ftom their choices alone or even much at all. It might be from a crit sequence or stuff like that.

But, it is interesting to imagine some very serious tactical exploits. PC drops, then an enemy cleric uses healing word and an attack cantrip to put them to zero a second time causing another level of exhaustion. This is better than trying to rack up death saves because any healing word from the PCs flush those, but its exhaustion that keeps carrying over.

I mean, unless allies can actually slap major heals on... this can get weird pretty quick.
 

Doc_Klueless

Doors and Corners
How often are PCs dropping to 0 hp in your game such that a house rule is needed? My experience is that it doesn't happen very often once past apprentice tier and my challenges can be very difficult.
It's a very rare event in the games I run as the players really do their best to stack the deck in their favor before engaging the enemy: scouting, fact finding, etc. Really, the threat of gaining a level of Exhaustion is more fear inducing than being killed! Ha!

Oh gods, please google the half dozen threads where this exact idea has already been discussed to death.
Or you could just ignore a thread that you don't really have any interest in instead of telling others how and what to post? I mean, there's no reason to be openly hostile and rude to the OP.

The easiest solution that fits all of these is to give some other penalty that only lasts for the combat they went down in.
Nah. The easiest solution is just to play the game RAW. ;) :LOL: But to build more constructively on this, perhaps have such "Combat Exhaustion" recovered on a short rest? Or have the PC lose a temporary point of Con or some such that's recovered with rest? So many options if the whole "wack-a-mole" thing bothers you.

I can understand why others would really not like our houserule (Blue, for example). But we (my gaming group) really like it for some odd reason, so I thought I'd share how we do it with the OP.
 
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Retreater

Adventurer
I had this very issue several times during a game I ran this weekend. During a climactic encounter with a solo green dragon, there were a couple of times when the ranger and paladin both dropped. A bonus action from the cleric mitigated all threat to a dying character and allowed them to jump back into the fight immediately. Then a mass cure wounds stabilized, healed, and got every character back into the fight. There was absolutely zero threat of character death - no one beyond one failed death save.
I'm wondering if house ruling that first curative magic stabilizes a dying character, then the next one restores actual HP? Or maybe that it takes a full move to stand up from prone? Or maybe give a character a maximum number of death saving throw failures of the course of their adventuring career?
This is one of the mechanics that makes 5e too easy. Needs some serious house ruling.
 

iserith

Magic Wordsmith
It's a very rare event in the games I run as the players really do their best to stack the deck in their favor before engaging the enemy: scouting, fact finding, etc. Really, the threat of gaining a level of Exhaustion is more fear inducing than being killed! Ha!
I'm trying to figure out like how often are people dropping in games that a house rule to ostensibly combat that is seen as desirable. I don't see it happen very often and so I wonder if there's not something else going on that could do with addressing rather than adding a house rule. What is happening at these tables that is not happening at mine, I wonder? Either the frequency of unconscious PCs is higher for some reason or the tolerance for it happening is lower. Or something.
 

5ekyu

Adventurer
I had this very issue several times during a game I ran this weekend. During a climactic encounter with a solo green dragon, there were a couple of times when the ranger and paladin both dropped. A bonus action from the cleric mitigated all threat to a dying character and allowed them to jump back into the fight immediately. Then a mass cure wounds stabilized, healed, and got every character back into the fight. There was absolutely zero threat of character death - no one beyond one failed death save.
I'm wondering if house ruling that first curative magic stabilizes a dying character, then the next one restores actual HP? Or maybe that it takes a full move to stand up from prone? Or maybe give a character a maximum number of death saving throw failures of the course of their adventuring career?
This is one of the mechanics that makes 5e too easy. Needs some serious house ruling.
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.
 

Doc_Klueless

Doors and Corners
Either the frequency of unconscious PCs is higher for some reason or the tolerance for it happening is lower. Or something.
Possibly.

For my groups sake, I suspect that dropping is actually rarer than most groups because I run such an over-the-top, gonzo, beer-n-pretzels type game where it is nearly impossible (but not completely) to die. I prefer Defeated rather than Killed. Our particular games would drive those looking for more "realistic," serious games INSANE! :D For example, one of the reasons we like Greyhawk is that one of the contries is called the Grand Duchy of Geoff. HA! And one of the main setting NPCs packs Wild West Revolvers! And a male, elf wizard is called Melf.

Our houserule was actually suggested by one of the players who had the buy-in from the other players so I ran with it. So I'm not exactly sure what flowchart/algorithm/etc. was used to come up to the point where we're at. I know that it almost never (I think only once) has had an impact on the NPCs.
 

tetrasodium

Explorer
I'm trying to figure out like how often are people dropping in games that a house rule to ostensibly combat that is seen as desirable. I don't see it happen very often and so I wonder if there's not something else going on that could do with addressing rather than adding a house rule. What is happening at these tables that is not happening at mine, I wonder? Either the frequency of unconscious PCs is higher for some reason or the tolerance for it happening is lower. Or something.
I think it's more the gamification of it being too absurd. I've seen games where the players realize getting hit for 42 hp with one hit point left is the same as having 41 hit points & then kinda playing pingpong up/down/up/down. In my game I use potion flasks & rebalanced potion benefits. Drink from a potion flask & roll your flask die (d6 or d8 for most of my table), If you get anything but a one great roll your healing, if you get a one roll your healing & your flask die drops a die size (ie d8 d6 d4 1). The healing from that flask is 2hd+2 but my players still act like drinking it in combat is beneath them because they can just soak it. As a result, the death saves they pile up only clear 1/long rest. It's really their own fault if they even go down under those conditions.
 

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