Some D&D 4e players and DMs feel that certain aspects of the healing rules reduce the PCs' risk of death to an almost negligible degree. In particular, the unlimited use of healing surges during short rests and the full recovery offered by extended (six-hour) rests strikes some as cushioning PCs too much. If you agree with this assessment but aren't sure what to do about it, purchase "Rugged Adventures" without any further delay. In this very well-written supplement, Andrew Wilson tweaks the 4e rest and leveling subsystems in order to make PCs feel a sense of fatigue and danger much more dramatically. Essentially, the "Rugged Adventures" system redefines short rests as six hours, with a minimum sixteen-hour gap in between (just like extended rests in standard 4e), and redefines extended rests as two days of downtime, like a weekend off from adventuring. Before you object with a "what about …?" question, rest assured that Andrew has thought through the implications very thoroughly, and the whole replacement system coheres very well. If you want to slow your campaign down to about one fight per day, turning encounter powers into daily powers and daily powers into weekly powers, Andrew's modifications provide a robust system by which you can meet those goals.
The thing is, I don't personally agree with those goals. In my view, "Rugged Adventures" very skillfully reintroduces the five-minute adventuring workday, something that the 4e designers explicitly set out to exorcise from D&D. Andrew is very explicit about this: "Don't put two encounters in the same day," he repeats twice on p. 6. This brings us right back to the game rhythm the 4e designers wanted to avoid: the party gets into a fight that lasts a minute or less, and then holes up to rest until the next day. "Rugged Adventures" paints this adventuring rhythm as a virtue, but I don't see things that way. Thus, "Rugged Adventures" offers something I don't want. If you want to bring one-encounter days to your 4e games, though, "Rugged Adventures" is the way to do it.
[3 of 5 Stars!]