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It's all surname to me. There's a family in my town with the last name Tiernan, so that's what I think of. As a first name, I think it falls under the category of Irish-American-trendy. It's a cool sound and meaning and all, but I'd never use it myself.

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Anyway, some middle name suggestions:
Tiernan Andrew
Tiernan Daniel - I actually really like the sound of this.
Tiernan Richard
Tiernan Patrick
Tiernan George
Tiernan Isaac
Tiernan Gabriel
Tiernan Frederick
Tiernan Samuel
Tiernan Oliver
Tiernan William
Tiernan Edward
Tiernan Christopher
Tiernan Zachary
Tiernan Jeremy / Jeremiah
Tiernan Michael
Tiernan Marcus / Mark
Tiernan Peter
Tiernan Paul
Tiernan John
Tiernan Oscar

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Any of these appeal to you?