Heal Skill Rework (PEACH)

[Durzan]

I have reworked the heal skill to be a tad bit more useful, particularly in campaigns where the players have little or no access to healing spells. I'd like to hear your thoughts on it below.


Heal (Wis)

You are skilled at tending to the ailments of others.

Identify Drugs or Pharmaceuticals (Trained Only): You may use the the Heal skill to identify Drugs and Pharmaceuticals.

Detect Contagion (Trained Only): You may use the heal skill to attempt to identify the source of poison or disease. Success allows you to detect the disease or poison as though you had cast Detect Poison on the subject. Failure by 5 or more indicates you misidentify the source. The DC varies based on the circumstance.

Stabilize: As a Standard Action, you may make a Heal check (Base DC 10 + Number of HP Below Zero) in order to save a dying character. If a character has negative hit points and is losing hit points (at the rate of 1 per round, 1 per hour, or 1 per day), you can stabilize the character. A stable character regains no hit points but stops losing them.

If you have at least 1 rank in the Heal skill, then a Heal Check made to stabilize a character allows that character to regain 1 HP for every 2 points by which your check exceeds the DC. The damage healed by stabilizing them cannot heal a person above 1 HP.

You may only use this feature if someone is unconscious and dying.

First Aid (Trained Only): You may make a Heal Check (Base DC 15) in order to immediately treat a person’s wounds. If you succeed on the check, your patient recovers a number of HP equal to 1d8 + your Wisdom Modifier (Minimum of +1). In addition, for every two points by which your check result exceeds the DC, the patient converts 1 additional point of damage into 1 point of non-lethal damage. Failing the check by 5 or more instead deals 1d8 points of damage to the patient.

Treating someone with First Aid requires you to spend one use of a Healers Kit, and takes a full minute to successfully accomplish. Attempting to give someone First Aid without the use of a Healer’s Kit incurs a -2 penalty to the check. A character may attempt to give someone First Aid as a full round action, but doing so incurs a -5 penalty to the check.

A patient may normally only receive the benefit from first aid once per encounter. Any additional attempts at first aid beyond this prove to be ineffectual.


Surgery (Trained Only): A character with at least 5 ranks in the Heal skill may make a Heal Check (Base DC 20) in order to put the subject into a relaxing state of temporary unconsciousness, allowing the patient to be treated more effectively. This ability otherwise functions similarly to First Aid, but allows you to heal an amount of damage equal to 3d8 + your Wisdom Modifier (Minimum of +1). In addition, for every point by which your check result exceeds the DC, the patient converts 1 point of damage into non-lethal damage.

Treating someone via Surgery requires you to spend two uses of a Healers Kit, and takes a full 10 minutes to successfully accomplish. A character may attempt to rush the surgery attempt in half the amount of time, but doing so incurs a -5 penalty to the check.

A patient may normally only receive the benefits of surgery once in a 24 hour period. Any additional attempts prove to be ineffectual.


Treat Wound from Caltrop, Spike Growth, or Spike Stones: A creature wounded by stepping on a caltrop moves at one-half normal speed. A successful Heal Check (Base DC 15) removes this movement penalty.

A creature wounded by a spike growth or spike stones spell must succeed on a Reflex save or take injuries that reduce his speed by one-third. Another character may remove this penalty by taking 10 minutes to dress the victim’s injuries and succeeding on a Heal check against the spell’s save DC.

Treat Poison or Disease: As a Standard Action, you may tend to a single character who has been poisoned and who is going to take more damage from the poison (or suffer some other effect). Every time the poisoned character makes a saving throw against the poison, you make a Heal check. The poisoned character uses your check result or his or her saving throw, whichever is higher.

Treating a disease functions similarly to treating a poison, but doing so is a little more complicated, requiring 10 minutes of work instead of a single standard action.

The DC for the Heal Check is the same as the save DC of the relevant Poison or Disease.

Long-Term Care: By making a successful Heal Check (Base DC 15) each day you care for a wounded person, you may double their recovery time. As long as your Heal Checks are successful, the patient recovers hit points or ability score points (lost to ability damage) at twice the normal rate: 2 HP per level for a full 8 hours of rest in a day, or 4 HP per level for each full day of complete rest; 2 ability score points for a full 8 hours of rest in a day, or 4 ability score points for each full day of complete rest.
If you beat a Heal Check (Base DC 25), all patients recover all HP in a 36 hour period instead of doubling their recovery time like normal.

You may tend more than one patient at the same time, but each additional patient beyond the first five increases the DC by 2 (All patients are affected by the results of the DC). You need a few items and supplies (bandages, salves, and so on) that are easy to come by in settled lands. Giving long-term care counts as light activity for the healer. You cannot give long-term care to yourself.

[Durzan]

What do you guys think?

[johnbragg]

It's an improvement.

Is it a big enough improvement to justify rewriting part of the game?
Does it make the Heal skill even a complement to cure X wounds?

First Aid actually healing damage is nice. Converting to nonlethal damage is extra bookkeeping--if I steal this, I would just write it as "Recover 1 additional hit point per hour for the number of hours your check exceeds the DC."

For Long Term Care, I'd also build in a threshold (probably DC 25) where patients recover all HP over a 36 hour period (2 sleeps and a rest day). That's practically the same as 3X natural healing, but sounds better.

[jqavins]

It's certainly more useful. It's so much more useful, and so wide ranging in it's facility, that I think you've turned a single skill into a low tier class by itself. Seriously, if you make some of these scale with level and add just one or two more you'd have a viable tier 4 or 5 medic class.

That said, if you want a skill that powerful, here are a few comments.

First Aid (Trained Only):...
Treating someone with First Aid requires use of a Healers Kit, and takes a full minute to successfully accomplish. Attempting to give someone First Aid without a Healer’s Kit increases the DC by 2. A character may attempt to give someone First Aid as a full round action, but doing so increases the DC by 5.

Surgery (Trained Only):...
Treating someone via Surgery requires use of a Masterwork Healers Kit, and takes a full 10 minutes to successfully accomplish. Attempting to give someone First Aid without a regular Healer’s Kit increases the DC by 2. A character may attempt to rush the surgery attempt in half the amount of time, but doing so increases the DC by 5.In both cases, you state "This use requires a special thing and a given time. If you don't have the thing or choose to take less time you can do it anyway." I think you need to reword these.


Treat Wound from Caltrop, Spike Growth, or Spike Stones:...
A creature wounded by a spike growth or spike stones spell must succeed on a Reflex save or take injuries that reduce his speed by one-third. Another character can remove this penalty by taking 10 minutes to dress the victim’s injuries and succeeding on a Heal check against the spell’s save DC.Caltrops don't come from a spell, but the description explicitly addresses Spike Growth and Spike Stones spells, and refers to their save DCs. So what about caltrops?


Long-Term Care:...
You can tend more than one patient at the same time, but each additional patient increases the DC by 2 (All patients are affected by the results of the DC). You need a few items and supplies (bandages, salves, and so on) that are easy to come by in settled lands. Giving long-term care counts as light activity for the healer. You cannot give long-term care to yourself.Giving long term care can be difficult, but not very much. I agree that should it count as light activity. That's why a +2 to the DC for each additional patient seems excessive. I'd only add one or two for each patient beyond the first five.

[Climowitz]

Long care treatment should allow to heal up to Dex Mod number of creatures with known phisiology before adding to the dc. First aid should not allow to heal a creature beyond 0 hp, or you face too much healing power without heavy investment. Also surgery should allow only to recover hit points, skill points and atribute due to losing a limb or extremity. Poison treatment should also neutralize at least half of it's damage if heal check beats poison dc. These are some thought so the skill isn't too powerful

[jqavins]

I'd meant to say the same thing about not healing beyond 0 hp, so thanks, Climowitz, for catching that one. But why Dex mod? The issue with multiple patients, it seems to me, is the work load over the course of a day much more than it is literally juggling tasks in a given moment. If it goes by any ability mod, I'd use Con. And I'd still make it something like 2 + Con mod (minimum 3) without penalty.

[Durzan]

First aid should not allow to heal a creature beyond 0 hp, or you face too much healing power without heavy investment. Also surgery should allow only to recover hit points, skill points and atribute due to losing a limb or extremity. Poison treatment should also neutralize at least half of it's damage if heal check beats poison dc. These are some thought so the skill isn't too powerful

Why the Dex mod?

The Stabilize feature already addresses the save someone from dying aspect and is limited in the fashion you suggested. Having First Aid not be able to heal above 0 HP would nullify one of the entire points of the rework, as that is basically what First Aid does in the SRD.

The First Aid is supposed to vaguely mimic Cure Light Wounds by healing 1d8 + Wis Modifier of Damage, as an action that takes 1 minute of work (or 1 full round if you rush it). Thats the equivalent of Cure Light Wounds, but because of the time it takes, it is also much less effective than the spell. Any excess HP cured due to beating the DC converts Damage to Non-Lethal on a 1:2 ratio, which emphasizes that bandages cant instantly heal all of someones damage like magic.

Surgery is a modifier that improves upon basic First Aid. It heals a total of 3d8+Wis Modifier worth of HP after 10 minutes of work (5 if you rush it), but the target needs to be unconscious for it to work. Thats the equivalent of Cure Serious Wounds, but because of the time it takes, it is also much less effective than the spell. Any excess HP cured due to beating the DC converts Damage to Non-Lethal on a 1:2 ratio, which again emphasizes that mundane medical abilities can only do so much. I COULD limit Surgery to where you could only perform effective surgery once per day on each individual person.

Having the function of Surgery do anything else adds unneeded complication, especially when ability damage due to loss of limbs is a condition you rarely see occur in most D&D games. If the DM comes across a situation where that is necessary, then it can be hand-waved as part of the surgery process.

Poison/Disease treatment were literally copied from the SRD. I just changed the wording slightly so it would take up less space. Altering it in the way you suggested would be a buff over that original aspect of the skill. When you are concerned about how powerful the skill is, buffing something is the last thing you should be suggesting.

Caltrops and such were also copied from the SRD.

The wording for First Aid and Surgery requiring healing kits was stolen from the Pathfinder SRD. Being able to rush the work of First Aid or Surgery makes sense, given you take a penalty. Taking a penalty to a check is effectively the same as raising the DC by the same amount.

The power of the Healing skill in this rework is to reflect the consideration for campaigns where the characters have lower access to healing magic, on top of making the skill more generally useful and to allow a certain reflection of realism (IE, that you can heal someone to some degree beyond stabilizing them with first aid). I am also the type of GM who likes to use skill checks a lot in my campaigns.

Having the powers scale in effectiveness by ranks encourages people to actually put more than just a few skill ranks into the skill.

Finally, I decided to update the original posts based loosely off of some of the suggestions given so far.

[Goaty14]

-Can identifying drugs and pharma also figure out the difference between a healing potion and a vial of acid?

-What is the normal amount of time to apply first aid? Nothing is listed as of now.

[Climowitz]

But there is no limit to the times one can use first aid. So with ten minutes i would rather make 10 First Aids instead of 1 surgery. Not to mention if i can perform it in 6 seconds, i can have 100 First Aids in the time of a Surgery, meaning a possible healing equal to 100d8 + 100 * Wis.

Also i added Dex because you need to be tending many people fast and that requires some dexterity and precision.

[jqavins]

Also i added Dex because you need to be tending many people fast and that requires some dexterity and precision.
But, since you only need to attend each patient once or twice a day, it isn't fast. Tiring, yes, but not fast.

[Durzan]

-Can identifying drugs and pharma also figure out the difference between a healing potion and a vial of acid?

-What is the normal amount of time to apply first aid? Nothing is listed as of now.

Yes, Identifying drugs and Pharma would probably include something along those lines. That bit is more up for GM interpretation to implement. (I literally just stole that line from the Pathfinder Heal skill)

For the time to apply first aid:

You may make a Heal Check (Base DC 15) in order to immediately treat a person’s wounds. If you succeed on the check, your patient recovers a number of HP equal to 1d8+your Wisdom Modifier (Minimum of +1). You also recover 1 additional hit point per hour for the number of hours your check exceeds the DC. Failing the check by 5 or more deals 1d8 points of damage to the patient.

Treating someone with First Aid requires use of a Healers Kit, and normally takes a full minute to successfully accomplish. Attempting to give someone First Aid without a Healer’s Kit incurs a -2 penalty to the check. A character may attempt to give someone First Aid as a full round action, but doing so incurs a -5 penalty to the check.

The part in bold specifically mentions the base time.

[Durzan]

But there is no limit to the times one can use first aid. So with ten minutes i would rather make 10 First Aids instead of 1 surgery. Not to mention if i can perform it in 6 seconds, i can have 100 First Aids in the time of a Surgery, meaning a possible healing equal to 100d8 + 100 * Wis.

Yep. That does need to be fixed.

I don't really want to limit the number of first aid attempts to a number of times per day, because as stated earlier this is supposed to be a mechanic for low magic campaigns, and I don't think I know of too many skill mechanics where you are limited to doing it a certain number of times per day.

Possible solutions:

Reduce the amount of Damage healed via First Aid with one check. Maybe simply make the amount of damage healed equal to 2 + 1 for every 2 points above the DC. If you attempt to rush the heal check (reducing it from a full minute to a full round), you halve the amount of HP you heal. HP healed in this manner is always converted to Nonlethal damage on a 1:2 basis (1 damage converts into 2 nonlethal).
Multiple First Aid attempts don't work on wounds that have already been treated (Hard to impliment, but somewhat realistic)
Limit the number of attempts to a number of times per encounter, or something like that.


Surgery could also use some other benefits, like allowing you to reattach limbs (though as I stated earlier, that doesn't happen very often, so writing rules for it might be more of a pain than its ultimately worth). Although if you noticed the change made to healing, I made it so that First Aid halves the amount of HP healed due to beating the check... so thats something

Any other ideas?

[jqavins]

Multiple First Aid attempts don't work on wounds that have already been treated (Hard to impliment, but somewhat realistic)I was thinking along this line. After all, there's a reason it's called first aid; any further treatment must be something more advanced. That translates to a limited number of uses per patient per fight. Now, what that limit is depends on how complicated you want to get. Some possibilities are:
Once.
Once for each wound taken suffered, each attempt limited in its healing ability to the damage taken in the wounding less something (so that simple first aid can't heal everything). But that requires players to log every hit they take separately and track what's been treated, which is a giant PITA.
Once for each serious wound, for example wounds of 10 HP or more, with the same "can't heal it all" limitation. Then players only have to track the big hits, so the PITA is smaller.
Three times.
Three times or once per hit, whichever is less (so counting of hits goes one, two, three, many) still with the limit of less than all points healed per wound. I like this best, but it's still a bit complicated, even tracking only three hits.
Three times or once per hit, whichever is less, where the "can't heal everything" limit only applies to the total. This may be the best compromise.
Etc.One way or another, it's not a limit on the healer, but on the patient's ability to benefit. That way, there's no X times per day or X times per encounter limit on the skill itself.

[Climowitz]

If you desperately need it to heal make it so it heals once per encounter and turns the rest to non lethal damage. That way healing gets done slowly over time like real first aid.

[Durzan]

If you desperately need it to heal make it so it heals once per encounter and turns the rest to non lethal damage. That way healing gets done slowly over time like real first aid.

Which was how it was originally (except the once per encounter bit). Then someone complained that converting it to nonlethal added an extra layer of book keeping... when in reality it is just using already established mechanics to simulate the healing process.

[Durzan]

Update: Tweaked the numbers and wording a bit.

Specifying that it converted all non-healed lethal damage to non-lethal could potentially be game breaking IMO. So I just reverted one of my previous changes instead. I also simplified the mechanic slightly to reduce the required amount of bookwork.

First Aid now converts 1 point of lethal damage to 1 point of non-lethal for every two points by which your check result exceeds the DC. Surgery does the same thing, but converts at the rate of 1 point converted for every point your check exceeds the DC.

First Aid now has a limit of once per encounter, while Surgery has a limit of once per day.

(Oh and Bump.)