Combat Realism - Hit Point recovery (5e Variant Rule)

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Combat Realism - Hit Point recovery[edit]

Combat in Dungeons and Dragons 5th edition is a well-balanced but somewhat abstract system where success is determined by an attack roll versus an armor class (AC), followed by a damage roll that reduces the target's hit points (HPs). HPs play a role in allowing higher level characters and those in martial classes to fight stronger opponents. To some extent, this is an abstract value that does not just reflect toughness but also skill. But if you use variant rules to improve combat realism or if you consider damage taken from a fall, or while unconscious, etc, then those hit points should represent true injury. A separate wiki covers more realistic scaling of maximum Hit Points. However the over-generous system for healing those injuries through rest also needs addressed.

Proposed here is a more credible HP recovery system for rest, while also highlighting the value of a healer in the party.

Official options[edit]

It is important to note that the DMG provides 3 official options to make healing a little more realistic. These will not be reproduced in any detail here but all slow HP recovery to various degrees:

- Healer's Kit Dependency

- Slow Natural Healing

- Gritty Realism

Homebrew option[edit]

Short rest: Very little actual healing happens in 1h, but important stabilizing is possible - stopping blood loss, replacing fluids, cleaning/covering/stitching wounds, strapping joints, splinting bones, etc. Allowing a single Hit Dice (plus CON bonus) to be spent per short rest is reasonable, assuming at least one party member has appropriate skills. Consider requiring a skill test for this.

Long rest: No-one heals major injuries in a single night. Allow a single Hit Dice (plus CON bonus) to be spent (without skill test). Regain a single Hit Dice.

Healers: An optional Cleric cantrip (or ritual cast spell) limited to once per night could allow a single player to regain additional Hit Dice (1 at 1st level, 3 at 5th level, 3 at 11th level and 4 at 17th level), while a full day's care with a Healer within the Party or a Village/Town NPC would allow all Hit Dice to be regained.


See Combat Realism - Defense and Armor Options for core rules to increase combat realism. _RM_

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