These are house rules that I use for my 5th Edition Dungeons & Dragons games.
Magical Healing and Hit Dice
Whenever a creature receives magical healing, that creature can expend hit dice to heal as if it had taken a short rest, with the following limitations:
- For each d8 (or higher die) of magical healing received, it may spend one hit die.
- For each d4 or d6 of magical healing received, it may spend one hit die, but the die type is dropped one category; so a d12 becomes a d10, a d10 becomes a d8, etc.
So if someone casts cure wounds on you through a level 3 spell slot, you can expend three hit dice. If someone casts mass healing word, then each target may expend one hit die, dropped by one category, so the wizard would roll a d4 instead of a d6, for example.
Note that for each hit die expended, the creature adds their constitution modifier to the roll, just as they would during a short rest.
Healing has always sucked, and in 5th Edition rules it sucks even more, where damage output greatly outstrips the ability of even a full divine caster to heal. This ruling makes healing feel much more impactful and much more attractive as an action to take in combat.
This also make expending higher level spell slots for more effective healing a viable strategy, which is important because after cure wounds, there isn’t another good single-target heal until the heal spell.
(Speaking of which, it’s worth considering changing the healing of heal from a constant to a dice roll. My groups don’t usually play at that level, so it hasn’t come up.)
Rolling Dice for Lay on Hands
Paladins do not have a pool of hit points for lay on hands. Instead, they have a pool of d8 healing dice equal to their paladin level. Each time they use lay on hands, they may expend any number of these dice to heal the target for the amount rolled on these dice.
The reasoning here is two-fold: boosting the ability while preventing abuse.
First, Lay on Hands was too powerful as a way to keep bringing characters back to consciousness by healing for one hit point, offering the ability for a level 3 paladin to effectively counteract fifteen sources of damage per day with a single class feature. This was also a very dull and repetitive way to run combat.
Second, this allows easy integration with the Magical Healing and Hit Dice house rule. It allows the paladin to heal for more hit points when combined with that, even though a d8 averages slightly less than 5 hit points.
Unconsciousness and Exhaustion
Every time you become unconscious as a result of dropping to 0 hit points, you suffer one level of exhaustion.
The most efficient way to heal is to wait for your ally to drop to 0 hit points, then bring them back to positive hit points with a spell before they die. Since damage in excess of the target’s current hit points is ignored anyway, it’s best to let the low hit point character soak up that extra damage by letting them drop before you heal them. This penalty disincentivizes that strategy.
Healing from unconsciousness may not be super powerful (but maybe it is), but more importantly it’s boring. I always hated encounters in which the central focus became repeatedly healing a character after they were dropped to 0 hit points.
Items in Hand
At the start of each turn in combat, a player chooses which item(s) their character has in their hand(s), provided that retrieving or readying that item does not take an action, as a shield does. Drawing any other items requires an action.
I give allowances for thrown weapons, like javelins, that would need to be drawn in order to take advantage of the Extra Attack class feature.
Basically I got tired of hearing this sort of ridiculous thing:
- “I have my shortsword and my bow in my hands, so I drop my shortsword as a free action, attack with my bow, then draw my other shortsword as an item interaction so I’m ready to make an attack of opportunity.”
- “I drop my dagger in my off-hand as a free action, draw my net as an item interaction, attack with my sword in my main hand, then bonus attack with the net in my off-hand, then attack again with my sword in two hands with my extra attack class feature.”
In addition to being cheesy, these are really tedious to parse in order to make sure that my players aren’t taking too many liberties, as some of them often have, mostly (I presume) from misreckoning, and not from an intention to cheat.
This also gives players a little bit of a boost, allowing them to quickly switch from using their longbow to swinging their sword when the enemy closes to melee.