D&D 5E House Rule Idea: conscious but Exhausted at 0 HP

[BookTenTiger]

I came up with this House Rule idea the other day. What do you think of it?

Purpose: This house rule is meant to replace the Unconscious condition that occurs for characters at 0 hp. This house rule is meant to keep the players of "dying" characters involved in combat, while also introducing long-term consequences of falling to 0 hit points. Note that this rule would only apply to characters, not necessarily monsters or NPCs.

New condition: Staggered.

When a character reached 0 hit points, they are considered Staggered. A Staggered character suffers the following:

• The character immediately takes on one level of Exhaustion.
• At the start of each of the character's turns, the character takes another level of Exhaustion.
• When the character takes damage, they suffer a level of Exhaustion. Critical hits result in two levels of Exhaustion.
• Attack rolls against the character gain advantage.
• The character has disadvantage on Strength, Dexterity, and Constitution Saving Throws.

The Staggered condition ends whenever the character gains hit points. However, any levels of Exhaustion remain. The character may reduce their level of Exhaustion through Long Rests or other means, as normal.


In my mind (having not playtested this at all), this house rule would result in some of the following changes:

• Characters at 0 hp would still be the targets of attacks.
• Characters at 0 hp would have more strategic choices to make, rather than just a death saving throw.
• Characters would still "bounce back" from 0 hit points, but gain the ongoing consequence of Exhaustion.

What do you think?

 

[loverdrive]

It kinda breaks the game, because all the healing mechanics are designed around getting unconsious characters back up. Otherwise, it just doesn't work -- aside of some very high level spells you'll never be able to heal more damage than the character takes in a single round.

 

[BookTenTiger]

It kinda breaks the game, because all the healing mechanics are designed around getting unconsious characters back up. Otherwise, it just doesn't work -- aside of some very high level spells you'll never be able to heal more damage than the character takes in a single round.

I'm a little confused by what you mean by this, but I want to understand.

The Staggered condition House Rule just replaced Unconscious as a condition. So characters at 0 hp could still be healed as normal to regain hit points and leave the Staggered condition.

Are you saying that healing spells would be ineffective because Staggered characters would still be the target of attacks, whereas unconscious characters wouldn't be?

 

[loverdrive]

I'm a little confused by what you mean by this, but I want to understand.

The Staggered condition House Rule just replaced Unconscious as a condition. So characters at 0 hp could still be healed as normal to regain hit points and leave the Staggered condition.

Are you saying that healing spells would be ineffective because Staggered characters would still be the target of attacks, whereas unconscious characters wouldn't be?

No, I mean that going down to 0 HP just three times (which can certainly happen, especially in the span of several encounters) basically makes the PC a liability, until they take several long rests.

 

[Charlaquin]

On paper, this looks like it would very quickly result in a death spiral. Though, that might or might not be an acceptable or even desirable result.

I’ve experimented with similar house rules. Generally, I have characters at 0 hp have to concentrate (as if concentrating on a spell) to remain conscious. If you take damage while at 0 HP, you take death save failures as normal, and have to save to maintain concentration. This way, it is a strategic decision whether to concentrate on staying conscious, remaining a target for your opponents but giving yourself an opportunity to take action to protect yourself such as fleeing, drinking a potion, etc. or to simply allow yourself to be removed from the combat.

In combination with this house rule, I have tried making death save failures cause levels of exhaustion instead of the 3 strikes you’re dead rule. What I’ve found is this results in a very gritty feel, where damage at 0 HP results in lasting injuries (represented mechanically with exhaustion levels). But it makes staying conscious at 0 almost never worthwhile, and things quickly spiral once PCs start taking exhaustion levels.

 

[BookTenTiger]

No, I mean that going down to 0 HP just three times (which can certainly happen, especially in the span of several encounters) basically makes the PC a liability, until they take several long rests.

Ah, I see. Thanks for explaining.

I guess my games are a little different, I have a character get reduced to 0 hp maybe once every 3 combats. But you are right, this would not be a good house rule for campaigns in which characters are reduced to 0 hp multiple times per combat.

 

[Charlaquin]

I'm a little confused by what you mean by this, but I want to understand.

The Staggered condition House Rule just replaced Unconscious as a condition. So characters at 0 hp could still be healed as normal to regain hit points and leave the Staggered condition.

Are you saying that healing spells would be ineffective because Staggered characters would still be the target of attacks, whereas unconscious characters wouldn't be?

I think what they’re getting at is, since in-combat healing is generally outpaced by damage in 5e, characters who become Staggered are pretty much screwed. You can heal them to remove Staggered, but the amount healed will almost always be less than the amount of damage they will take in the ensuing round, resulting in them being Staggered again and accumulating more exhaustion levels.

 

[BookTenTiger]

But it makes staying conscious at 0 almost never worthwhile, and things quickly spiral once PCs start taking exhaustion levels.

Good point! I hadn't considered the Death Spiral.

 

[BookTenTiger]

I think what they’re getting at is, since in-combat healing is generally outpaced by damage in 5e, characters who become Staggered are pretty much screwed. You can heal them to remove Staggered, but the amount healed will almost always be less than the amount of damage they will take in the ensuing round, resulting in them being Staggered again and accumulating more exhaustion levels.

That makes sense to me now. It's interesting how being Unconscious really creates opportunities for characters to regain HP and rejoin the combat!

 

[toucanbuzz]

I've been using, since around 2018, a somewhat similar Vitality homebrew (the actual damage your body can take, represented by your 1st level hit points, when you reach 0 HP, with HP reflecting the abstract of avoiding real damage) instead of death saves. Death saves led to absurd scenarios and we hated whack-a-mole.

Under Vitality, at 0hp all further damage is taken from your Vitality if you get hit and you take at least 1 Vitality damage just by hitting 0. Players have the narrative here: you opt to become Staggered and keep acting, albeit severely hampered, or go Unconscious. You can't keep getting so close to death without risk, so every time you go Staggered, you get a Death Point. Get 3 and you're dead. You don't get Death Points if unconscious, and they go away with long rests.

We went with 1st level hit points because it really doesn't matter if you're 20th level or 1st level, a sword to the gut can outright kill you, and if a giant's club or dragon's claw actually hits, you'll be dead. However, on the trek to level 20, players become a lot better at avoiding death (hence the extra hit points).

In the brainstorming, exhaustion mechanics came up, but they are brutally lethal and as @Charlaquin stated, quickly lead to a death spiral. Exhaustion is a crippling mechanic that largely punishes the front-line fighter types. Given there's no way, absent a high level cleric, to remove exhaustion, parties will cease exploring dungeons and be forced to hunker down for days. Casters are not crippled by it in the way fighters are.