Office nursing is its own specialty. A lot of what you do on a daily basis really depends upon the physician you work for. Some people confusing "office" with meaning it will be "slow" or "boring" but that was never my experience. Physicians, especially primary care doctors, take on a LOT of patients so you're not just managing the ones that come in for the day but also the ones that call the office for phone triage, medication issues, needing prior authorizations done for the new medication that the physician prescribed, etc. The doctor I worked for actually had TWO nurses because she was so busy during her 4 days in the office (we were usually there for 9-10 hrs each day). We took turns where I'd room patients and assist with procedures while the other nurses did "phone duty," prior authorizations, paper work, etc and then switched for the other two. I feel really lucky that had a doctor that wanted to grow her nurses to have critical thinking (both of us were new nurses when we first started) so we could manage a lot of issues without having to run to her each time. And even with her using fairly large appointment slot times (15-30 minutes.....the longest appt times utilized in our office. Others would have 5/10/15 minute appts) she would still have patients with multiple issues, "door handle problems" (where, as she's walking out the door, the patient would say "oh wait, while I'm here...." or unexpectedly complicated problems (i.e. told the receptionist they were coming in for diarrhea when it was really crippling new on-set anxiety) where she'd need to even pull the "phone" nurse into the mix to help keep the office flowing on time. There were rarely boring/slow moments....usually right before a holiday weekend.
Some things do get repetitious... but I think that they can anywhere. Flu/respiratory season got old pretty quick for me, but you see a lot of the same stuff in the hospital, just more advanced acuity.
As far as advancement goes....well, how far can a nurse really advance "even" in a hospital without increased education? Floor nurse --> charge nurse --> nursing supervisor....maybe house supervisor....? If you're not happy in your current setting I wouldn't say that means the whole hospital is not an option for you, there are specialties (or even just hospitals where the culture demands better ratios) where you will not get 1:9 ratios. Moving into outpatient care doesn't mean you can't go back to the hospital setting at some time in the future. The amazing thing about nursing is that there are so many options. Many people love outpatient nursing because of the very set schedules without weekends or holidays. You "pay" for that benefit in the form of a pay decrease, but it doesn't make you any less a nurse, highly trained within your own specialty. I've been out of the office for over 2 years so I know nothing about the new coding changes and I couldn't even begin to think of all of the various things I've forgotten about pediatric care, chronic disease management, acute sprains/strains/medium-acuity injuries, childhood vaccination schedules, etc. It's just a whole different world and there will be a learning curve no matter how much hospital experience you have.
To that point, I'm curious why your boss feels like she was somehow held back by working in an office.....when she's now an inpatient nurse manager. Again, there's not much higher up that one can go without additional education. Maybe she has more to her story or maybe she's trying to hold onto what little staff she has considering those awful ratios. Either way.... her story is her own, you only get to dictate yours. If you think it's time for a change, it's your decision to make.
Good luck with deciding.