D&D 5E House rule for in combat healing and yoyo at 0 HP

[Vendral]

As a DM for my group I have found that I dislike that my players (understandably) let their characters drop to 0 before doing any healing which causes the yoyo effect.
My players (again understandably) think it is really bad action economy to heal someone before they drop.
We have introduced two house rules to encourage in combat healing and discourage the drop to 0, be healed, and drop to 0 again yoyo effect.

1. A character getting up after being dropped to 0 have the effects of being slowed as per the slow spell for 5 rounds with no possibility to save to end the effect.
2. Any magical healing gives as many temporary HP as the actual amount healed. That is, if you have 5 points of damage and get Cur Light Wounds for 7 points you also get 5 temporary HP. Temporary HP from magical healing is not gained if you are 0 HP when healed.

These two rules together have changed how we play and my players and I really like it. To be frank they dislike rule 1 and try to avoid getting to 0 HP, but they love the added tactical effect of healing spells.
I wanted to share our solution to this, in case anyone else think this is a problem as well as find out if anyone else have a different approach to this issue.

EDIT: I did not initially include in house rule 2 that temporary HP is not gained when at 0 HP. It is now updated with that part as well.

 

[J-H]

I just do 1 level of exhaustion each time a character drops to 0 or gets killed.

 

[aco175]

Slow spell from DDBeyond:

An affected target's speed is halved, it takes a −2 penalty to AC and Dexterity saving throws, and it can't use reactions. On its turn, it can use either an action or a bonus action, not both. Regardless of the creature's abilities or magic items, it can't make more than one melee or ranged attack during its turn.

If the creature attempts to cast a spell with a casting time of 1 action, roll a d20. On an 11 or higher, the spell doesn't take effect until the creature's next turn, and the creature must use its action on that turn to complete the spell. If it can't, the spell is wasted.

Certainly makes you not want to be knocked down.

 

[Reynard]

Your players must like a dangerous game because waiting to heal until after getting dropped is both terrible action economy* AND invites a TPK. I'd let one happen and see how they change tactics.

*now someone has to adjust their entire round around saving that person before they get killed by Magic Missile.

 

[GMMichael]

These two rules together have changed how we play and my players and I really like it. To be frank they dislike rule 1 . . .

Yeah, me too.

and try to avoid getting to 0 HP, but they love the added tactical effect of healing spells.
I wanted to share our solution to this, in case anyone else think this is a problem as well as find out if anyone else have a different approach to this issue.

So, there's this thing called a "double tap." The point, I believe, is to deliver extra damage when shooting your opponent, to make sure she's dead/ out of the fight. If players know that their medieval opponents will do this - actually make sure they die - they'll use more in-combat healing. Without house rules.

 

[Vendral]

I have a stable group and I have been the DM/GM for several of the players for close to 40 years. They are well aware of when I (usually) attack downed players and when I don't so they base their tactics on that.
Undead lock on a target and keep attacking it until it is dead,
Monsters looking for food will try to drag unconscious characters away, generally doing damage as they go.
It is very seldom other NPC/enemies attack downed characters, and the players usually know which enemies do.
Doing "double tap" or in other ways actively trying to finish a PC without giving some heads up what is at stake is not something I want to do.

 

[jgsugden]

I do not find this a problem, but I understand why people do.

When addressing this as a problem, the most interesting solution was implemented in a game that used 'injuries'. A character sustained an injury if they took over half their maximum hps in damage in a round, or dropped to zero hps. They had several injury decks based upon the type of damage inflicted (with the DM deciding which to use in cases of multiple damage types). A player would draw 1 injury card when injured.

Some injuries inflicted a condition. Some granted effective levels of exhaustion. Some lowered ability scores. Some were minor - some were significant.

Each injury identified how it could be removed. Some could be removed through extended rest or magic - others only by magic.

It worked for that game - for a bit. In the short term it gave the game a sense of risk that the DM and (most of) the players wanted. Then, injuries began to add up and a few PCs were forced to retire because they couldn't heal their injuries and the PCs were ineffective with them. This left a bad taste in the mouth of the PCs. Eventually the decks were retired.

 

[Ruin Explorer]

As a DM for my group I have found that I dislike that my players (understandably) let their characters drop to 0 before doing any healing which causes the yoyo effect.
My players (again understandably) think it is really bad action economy to heal someone before they drop.
We have introduced two house rules to encourage in combat healing and discourage the drop to 0, be healed, and drop to 0 again yoyo effect.

1. A character getting up after being dropped to 0 have the effects of being slowed as per the slow spell for 5 rounds with no possibility to save to end the effect.
2. Any magical healing gives as many temporary HP as the actual amount healed. That is, if you have 5 points of damage and get Cur Light Wounds for 7 points you also get 5 temporary HP.

These two rules together have changed how we play and my players and I really like it. To be frank they dislike rule 1 and try to avoid getting to 0 HP, but they love the added tactical effect of healing spells.
I wanted to share our solution to this, in case anyone else think this is a problem as well as find out if anyone else have a different approach to this issue.

This is a more thoughtful solution than most because it recognises the key issue with healing in combat in 5E, which is that aside from yoyoing it is generally incredibly weak and wasteful as an action.

The vast majority of solutions to this are short-sighted - including some in this thread - because they don't understand that this is a two-part problem, not just "punish the PCs more for being down". 5E was designed with the awareness of yoyoing. No-one at WotC doesn't know yoyoing happens. Combat healing is weak because WotC intends that the majority of healing is either out of combat or yoyo stuff.

By giving THP you make it so in-combat healing makes sense, but out-of-combat healing isn't doubled in power. It's very good work.

If players know that their medieval opponents will do this - actually make sure they die - they'll use more in-combat healing. Without house rules.

That's not a good solution, because it's implausible for a lot of enemies to do that (untrained combatants, mindless undead, many animals/monsters), and further, it totally fails to recognise that his players are completely correct - in-combat healing in 5E is very wasteful in terms of both action economy and in terms of spell slots. It's dreadful - but that's an intentional from WotC - they think yoyoing is fine. Giving THP actually accounts for this, which your plan does not.

EDIT - your less extreme solutions still fail to recognise that this is a two-part problem stemming from WotC's intentional design. In combat healing in 5E isn't weak by accident or because people "don't try", it's weak because WotC want you to heal out of combat. If you want to make being downed more extreme to encourage combat healing, you also need to look at making combat healing worthwhile, and making it give additional THP is ideal.

 

[GMMichael]

It is very seldom other NPC/enemies attack downed characters, and the players usually know which enemies do.
Doing "double tap" or in other ways actively trying to finish a PC without giving some heads up what is at stake is not something I want to do.

So, the undead are more efficient killers than those with the braaaaaains? (so delicious)

The heads-up that a PC could die is delivered when you say "roll for initiative."

But if that's not your thing, you could ( and technically should) make a fallen PC useless for a round after being revived because he needs to A) pick up his weapon, and B) stand up before resuming his yo-yo spin. Another movement would likely be required after that, because what fight stays in one place?

 

[Staffan]

You could borrow a rule from Pathfinder 2 and add a "Wounded X" condition. When you stop dying (by being healed or through other means), you become Wounded 1 or increase your existing Wounded by 1. Should you go down again, you start with X failed death saves.

In Pathfinder, you lose Wounded by either having your wounds treated (which is a 10-minute activity requiring a Medicine skill check, but you also get some hit points back for it) or by having all your hp healed and resting for 10 minutes. The 5e equivalent would be taking a short rest.

It should however be noted that both healing and damage is significantly chonkier in Pathfinder than in D&D. The most common healing spell heals about half of a same-level fighter's hp, and can do so at a range of 30 ft, but on the other hand two hits from a same-level foe could deal between half and all of said fighter's hp in damage.