D&D (2024) Gain 1 exhaustion when dropping to 0hp?

[DEFCON 1]

My current Death & Dying rules for my Theros campaign that uses the Exhaustion chart in place of '3 Death Saves':

Rests

• A Short Rest is 10 minutes, during which you may spend hit dice to regain hit points and regain features that refresh on a Short Rest.
• A Long Rest is 8 hours of light activity or sleep, after which you regain all of your spent hit dice, regain all features that refresh on a Long Rest, and you lose your level of exhaustion if currently at Level 1 (creatures at any higher exhaustion levels do not lose any.) You do not automatically regain all hit points following a Long Rest. The effects of a Short Rest are included at both the beginning and end of a Long Rest. (I.E. you may spend any remaining hit dice you have at the beginning of the Long Rest to regain hit points, and then may spend any new hit dice you just regained following the Long Rest to regain more hit points.)
• An Extended Rest is 24 hours of uninterrupted bed rest in a safe location and counts as a Short and Long Rest. You regain all hit points, all hit dice, all class features, and may possibly reduce levels of Exhaustion you currently have. At the end of the Extended Rest another character may attempt a single WIS (Medicine) check for that character. Making DC 10 reduces your Exhaustion level by 1, reaching DC 20 reduces your Exhaustion by 2 levels, and reaching DC 30 reduces it by 3 levels.

Dying and Exhaustion

• When a creature reaches 0 hit points, they are Dying. They remain Dying until they are Stabilized.
• A Dying creature has the Incapacitated condition (instead of Unconscious) and at the start of each of their turns make Death saving throws with a DC 10 to succeed. (An Incapacitated creature can’t take actions or reactions but may still move.)
• Every level of Exhaustion a creature has raises the DC by 1.
• Each failed Death saving throw causes one level of Exhaustion.
• Death occurs at Exhaustion Level 6 as per the Exhaustion chart (and not 3 failed Death saving throws as normal.)
• A creature may regain hit points while Dying (via abilities, spells and items as normal), but that does not remove the Incapacitated condition, does not stop the rolling of Death saving throws, and does not adjust or affect their Exhaustion level. They are still considered Dying even though they are no longer at 0 HP.
• To no longer be considered Dying (and thus remove the Incapacitated condition and stop the rolling of Death saving throws) requires the target to be Stabilized.

Stabilizing a Dying Creature

• A Dying creature that makes three successful Death saving throws or rolls a Natural 20 on a Death saving throw automatically Stabilizes.
• Another character adjacent to an Incapacitated character can attempt to Stabilize them by using an Action to make a WIS (Medicine) check with a DC equal to the target’s current Death save DC.
• Stabilizing a creature does not remove any levels of Exhaustion.
• A Stabilized creature has however many hit points they have received (if any) while Dying. A Stabilized creature who was not healed while Dying is still at 0 HP but can act normally.

Combat While Dying or Stabilized

• Any successful attack made on a Dying creature immediately results in one automatic failed Death saving throw.
• Any attack on a Dying creature that has hit points does not cause hit point damage but rather still causes an immediate automatic failed Death saving throw.
• An attack on a Stabilized creature causes hit point damage. If the creature is at 0 HP or the attack drops them back to 0 HP, it immediately ends the Stabilization and they are considered Dying again.
• A creature that begins Dying again has their successful Death saving throws reset to 0. Their Exhaustion level is at wherever it was previously.

Exhaustion Chart

• Level 1: Speed halved.
• Level 2: Max HP halved.
• Level 3: Disadvantage on attack rolls and saving throws.
• Level 4: Disadvantage on ability checks.
• Level 5: Unconscious.
• Level 6: Death.

 

[Gubber Bittencourt]

that and recovering from exhaustion depends on the resting conditions (hot food, roof, campfire)

 

[ChameleonX]

I would prefer healing in general go back to 4th edition standards instead of this weird hybrid we have in 5th;

Bring back negative hit points. If you reach negative bloodied value you die, but any healing resets you to 0 and then counts up from there, so healing isn't wasted on negative hit points.

Most healing uses Hit Dice, which heal a set amount that scales with level so it's always half your bloodied value (e.g. One quarter of your max), so it's still a limited resource, but there's no possiblity of pissing away a 3rd+ level spell slot and rolling all 1s and 2s, etc.

Also, Death save failures only reset on a short or long rest, instead of every time you heal.