I use the following houserules:
I'm really surprised to see lots of house rules on slower natural healing or exhaustion when dropping to 0. That has to really slow the game down and be frustrating for the players. Players don't want to constantly enter combat at less than full strength. Players will simply spend more time resting and not adventuring. It also greatly increases the need for a dedicated healer.
D&D isn't the type of game for this level of real-world simulation. If you want an additional "burden" on players, I recommend enforcing the lifestyle rules and placing requirements on maintaining a certain lifestyle level to gain the benefits of healing.
I agree with you in general but I suspect this is mainly done by those looking for the feel of earlier editions where 1hp per level per night of rest was pretty common. The only fast healing was magical healing. The cleric lobby is strong![]()
While I haven't altered the rest/recovery mechanics at all, I do grant a level of exhaustion when a PC is knocked to 0HP. I find that this adds a certain gravity to going down that is otherwise not there. It also reduces the "whack a mole" effect that sometimes happens as a healer gets the fighter on his feet so he can attack and then go down again when a monster hits him, then the healer gets him back up, and so on.
If you mean modifications or additions to player characters material or actual rules of the game, I am using zero House Rules.
If you mean the metagaming kind of House Rules, I am mainly using two:
- allowing a player to choose an alternative fate in case her character dies
- vetoing intra-party violent conflicts, such as stealing or trying to kill another PC
Well it reduces the "whack a mole" effect because you've introduced something way more penalizing. Players will be less inclined to bring someone back during combat because they will be less effective. They are already most likely spending their action in combat - the most precious resource in the game - to bring back an ally that will be penalized. And if that ally goes down again, the penalty gets worse and worse (I assume the exhaustion levels are cumulative).
In addition, by discouraging bringing back allies during combat, you have now introduced a much higher chance of a TPK.
I'm really surprised to see lots of house rules on slower natural healing or exhaustion when dropping to 0. That has to really slow the game down and be frustrating for the players. Players don't want to constantly enter combat at less than full strength. Players will simply spend more time resting and not adventuring. It also greatly increases the need for a dedicated healer.
2 - Death and Exhaustion
To avoid players healing a few hp to a downed friend only to keep him up for a round, and not caring wether he/she gets knocked out again, when a player gets to 0 hp, and comes back to consciousness, he/she gains two levels of exhaustion.
This way, getting knocked out feels a little bit more dangerous, since you need a long rest to recover from a level of exhaustion. Three downs means death. And if you get knocked out two times, you better rest instead of going adventuring the day after.
But even with four level of exhaustions, the player can at least keep his/her main stats working... though admittedly, he/she won't be any good at anything else.