Variant: 4e Style Healing Rules

Many campaigns prefer to avoid "easy" or "medium" encounters, and prefer each battle to be a pitched, dramatic fight to the death. Unfortunately, while such encounters can be a lot more fun than a series of very easy fights, characters who take a few hard hits end up sitting out the majority of the action, especially if the party is limited on the amount of healing ability that they bring to the table.

Moreover, characters who do have healing abilities can often feel like they are sacrificing their own time in the spotlight to patch up the foolhardy or unlucky members of their party. They also have to use their own resources, like spell slots, in order to do so.

D&D 4th Edition had a good system for solving these problems. Every character had a limited way that they could heal themselves in combat, so no character was stuck sitting out for long. For healers, healing usually took a bonus action, so they were free to do something cool with their action. Also, the resource that was spent to do the healing was paid by the patient - so the healer did not have to sacrifice another cool ability to heal instead.

These changes below reflect this philosophy, and try to restore what was cool about 4th Edition's health system, without introducing the same problems that 4th Edition had: namely, that characters always seemed to have an unlimited supply of healing surges.

General Changes

All characters gain 2 additional hit die of the class they took at level 1.

Why extra hit die? All of the healing abilities in this variant ruleset trigger using hit die. Since a level 1 character only has one hit die to spend, they could only benefit once from these new rules, so the challenge was to pick a number of additional dice that allowed characters to see the full benefit of these rules immediately, without making high-level characters invincible. Two additional die seems to be the sweet-spot.

After a short rest, characters regain one lost hit die. After a long rest, characters regain up to half their maximum lost hit die, as normal.

Hit die may be “spent” in order to regain lost hit points. When a rest or an ability allows you to spend a hit die, roll your hit die and add your constitution modifier. You may also take half of the size of the die instead of rolling it. (d6=3, etc) You regain that many hit points. Mark off the spent hit die on your character sheet. If you have multiple sizes of hit die from different classes, you choose which die to roll.

All characters gain the “Rally” action.

Rally

As an action, your character may spend a hit die in combat to regain hit points. This represents your character very quickly setting a broken bone, gritting their teeth and redoubling their resolve, or simply kissing their good luck charm. As part of this action, tell the DM what your character does to heroically carry on.

At 5th level, you may spend up to 2 hit die to regain hit points. At 11th level you may spend up to a maximum of 3 hit dice, and at 16th level you may spend up to a maximum of 4 hit dice.

Class Specific Changes

Paladin

Replace the Paladin’s Lay on Hands ability with the following feature:

Lay on Hands (Revised)

As a bonus action, you may place your hands on an adjacent creature and channel divine power to allow them to heal their wounds and rally. They may immediately spend any amount of hit die to regain hit points. You may use this action a number of times equal to your charisma modifier (minimum 1). You regain all uses of this power after a long rest.

Artificer:

Replace the Artificer’s Healing Draught with the following feature

Adrenaline Shot

As a bonus action, you may produce a vial of stimulants which accelerate the healing process. As part of this bonus action, you may also administer this vial to an ally within 60 feet by use of a specially designed crossbow attached to your wrist. You automatically successfully administer the dose at range to a willing target you can see.

You may produce two vials, and regain all used vials after a short or long rest.

If you choose to instead give away the vial for later use, it loses its potency after one hour as the reagents break down.

An ally who drinks the vial as an action, or who receives the dose via crossbow can spend any amount of hit die to regain hit points.

Bard, Cleric, Druid:

Gain the “Natural Healer” class feature at level 1:

Natural Healer

As a bonus action, you send a burst of healing magic targeted at one ally within 60 feet of you. They may immediately spend any amount of hit die to recover hit points. You may use this ability twice, and you re-gain all uses of this ability on a short or long rest.